Provider Demographics
NPI:1215635628
Name:UAMS HEALTH COMPREHENSIVE CARE AT HOME, LLC
Entity type:Organization
Organization Name:UAMS HEALTH COMPREHENSIVE CARE AT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF TAX
Authorized Official - Prefix:
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGLICCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:3854 AMERICAN WAY STE A
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4897
Mailing Address - Country:US
Mailing Address - Phone:225-299-3701
Mailing Address - Fax:
Practice Address - Street 1:404 LLAMA DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4785
Practice Address - Country:US
Practice Address - Phone:501-268-2292
Practice Address - Fax:501-305-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care