Provider Demographics
NPI:1427240795
Name:ARKANSAS HOSPICE, INC.
Entity type:Organization
Organization Name:ARKANSAS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AURELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-748-3333
Mailing Address - Street 1:5600 WEST 12TH STREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1717
Mailing Address - Country:US
Mailing Address - Phone:501-748-3333
Mailing Address - Fax:501-748-3476
Practice Address - Street 1:202 N. RHODES ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-3944
Practice Address - Country:US
Practice Address - Phone:870-735-2824
Practice Address - Fax:870-735-2584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR4439251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARAR4439OtherSTATE LINCENSURER