NPI 1619501087
1 Source Senior Care
Practice location
- Address
- 1820 Shelby Ln STE a, Fayetteville, AR 72704-5255
- Phone
- (479) 443-7173
- Fax
- (479) 443-0183
Authorised official
- Name
- Cathy Robertson
- Title
- Owner
- Phone
- (479) 443-7173
Registered specialties (4)
In Home Supportive Care Agency
Primary
Case Manager/Care Coordinator
Case Management Agency
Respite Care
Registry record
- NPI
- 1619501087
- Entity type
- Organization
- NPI issued
- 25 Feb 2020
- Record last updated
- 26 Mar 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.