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CENTERWELL CERTIFIED HEALTHCARE CORP. NPI 1619909884


NPI Information

NPI: 1619909884
Provider Name: CENTERWELL CERTIFIED HEALTHCARE CORP.

Doing Business As: CENTERWELL HOME HEALTH

Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 04D0711333

Address:
2120 S WALDRON RD BLDG C
FORT SMITH, AR
ZIP 72903
Phone: (479) 452-0424
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CENTERWELL CERTIFIED HEALTHCARE CORP. is a home health in Fort Smith, AR. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. CENTERWELL CERTIFIED HEALTHCARE CORP. NPI is 1619909884. The provider is registered as an organization entity type.
The provider Is Doing Business As Centerwell Home Health.

The provider's business location address is:

2120 S WALDRON RD BLDG C
FORT SMITH, AR
ZIP 72903-689
Phone: (479) 452-0424
Fax: (479) 452-0960

The provider's authorized official is John Nichols .
The authorized official title is Authorized Official and has the following contact phone number (479) 452-0424.

The CLIA number assigned to this NPI record is 04D0711333 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 11/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1129056732MEDICAIDARKANSAS
2013100POTHERAR-COMMERCIAL NUMBER
3112135OTHERAR-COMMERCIAL NUMBER
4138833742MEDICAIDARKANSAS
5129054514MEDICAIDARKANSAS
6138832757MEDICAIDARKANSAS
7145489757MEDICAIDARKANSAS
8047038OTHERAR-COMMERCIAL NUMBER
9115712OTHERAR-COMMERCIAL NUMBER
10129054514 (AR)MEDICAIDARKANSAS
11138789752MEDICAIDARKANSAS
12145450752MEDICAIDARKANSAS
13145487738MEDICAIDARKANSAS
14145688732MEDICAIDARKANSAS
15140555765MEDICAIDARKANSAS
160564382OTHERAR-COMMERCIAL NUMBER
1711341402450OTHERAR-COMMERCIAL NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.