HARRIS SOUTHEAST CARE HOME (NPI# 1366590572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366590572 |
| Entity Type | Organization |
| Organization Name | HARRIS SOUTHEAST CARE HOME |
| Practice Address |
534 S 16th St West Memphis AR 72301-5631 |
| Practice Telephone | 8707321200 |
| Practice Fax Number | 8707339153 |
| Mailing Telephone | 8707321200 |
| Mailing Fax Number | 8707339153 |
| Enumeration Date | 2007-01-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. HELEN JEAN HARRIS (ADMINISTRATOR) |
| Authorized Official Telephone | 8707321200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
345 | AR | Nursing & Custodial Care Facilities |
| Street Address |
534 S 16TH ST |
| City | WEST MEMPHIS |
| State | AR |
| Zip Code | 72301-5631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755497 | Shannon Mcelroy | Pharmacist | 300 I-40 Service Rd, West Memphis, AR 72301 | 2020-06-23 |
| 1891319745 | Heather Nichole Fesperman | Nurse Practitioner | 420 W Cooper Ave, West Memphis, AR 72301 | 2020-06-05 |
| 1174161475 | Mary Williams | Pharmacist | 300 I-40 Service Road, West Memphis, AR 72301 | 2019-12-17 |
| 1336787035 | Yolanda Monique Fulton | Assisted Living Facility | 711 Purduve Ave, West Memphis, AR 72301 | 2019-12-13 |
| 1255813317 | Urgent Care Travel, Inc | Clinic/Center | 3400 Service Loop 2, West Memphis, AR 72301 | 2018-09-05 |
| 1841770302 | Cuffie Healthcare LLC | Home Health | 403 Ingram Blvd, West Memphis, AR 72301 | 2018-08-15 |
| 1467940312 | Mark Aaron Whitlock | Dentist | 110 Dover Rd, West Memphis, AR 72301 | 2018-04-26 |
| 1043715329 | Crossroads Treatment Center of West Memphis, PC | Clinic/Center | 103 S Avalon St, West Memphis, AR 72301 | 2018-03-28 |
| 1114445202 | Deborah Thompson Ferguson | Dentist | 200 S Rhodes St Ste B, West Memphis, AR 72301 | 2017-09-08 |
| 1154745487 | Erin Camille Greer | Specialist/Technologist | 610 N. Missouri Street, Suite 1, West Memphis, AR 72301 | 2014-02-06 |
| Find all providers in zip 72301 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659595551 | Crittenden Adult Care Services L.L.C. | Custodial Care Facility | 718 E Broadway St, West Memphis, AR 72301-4449 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881232536 | Trina Smith | Custodial Care Facility | 107 Summer Pl, Hot Springs, AR 71913-5165 | 2019-12-12 |
| 1306105945 | Legacy Healthcare Management, Inc. | Custodial Care Facility | 4800 W 13th St, Ste #d, Little Rock, AR 72204-1900 | 2012-05-15 |
| 1336356179 | Baxter Retirement Village | Custodial Care Facility | 550 W 6th St, Mountain Home, AR 72653-3420 | 2007-05-17 |
| 1942417795 | Mulberry Retirement Center | Custodial Care Facility | 949 N Main St, Mulberry, AR 72947-8538 | 2007-05-17 |
| 1578770335 | Harrison Retirement Center | Custodial Care Facility | 520 Harness St, Harrison, AR 72601-8905 | 2007-05-17 |
| 1700093507 | Greenwood Retirement Center | Custodial Care Facility | 1200 W Center St, Greenwood, AR 72936-3716 | 2007-05-17 |
| 1942344288 | Boeckmann and Sons | Custodial Care Facility | 1803 Lindauer Rd, Forrest City, AR 72335-2407 | 2007-02-19 |
| 1427139567 | Tippin Surgical Supply | Custodial Care Facility | 502 West Pennington Street, Ola, AR 72853 | 2006-10-17 |
| 1114485471 | Short Mountain Lodge Residential Care | Custodial Care Facility | 2721 W Walnut St, Paris, AR 72855-3642 | 2019-03-06 |
| 1548435563 | Community and Governmental Consultants Inc. | Custodial Care Facility | 100 Ridgeview Rd, Eureka Springs, AR 72632-9358 | 2008-04-30 |
| Find all providers with the same taxonomy | ||||
| City | WEST MEMPHIS |
| Zip Code | 72301 |
Please comment or provide details below to improve the information on HARRIS SOUTHEAST CARE HOME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.