- Enrollment id
- O20070201000026
- Enrollment state
- AR
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1932166402
- Multiple npi flag
- Y
- Ccn
- 041502
- Associate id
- 5991707127
- Organization name
- AREA AGENCY ON AGING OF WESTERN ARKANSAS, INC
- Incorporation date
- 1979-06-21
- Incorporation state
- AR
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 3600 WHEELER AVE
- Address line 2
- STE 2
- City
- FORT SMITH
- State
- AR
- Zip code
- 729016621