Provider Demographics
NPI:1447395439
Name:COMMUNITY LIFE SERVICES, INC.
Entity type:Organization
Organization Name:COMMUNITY LIFE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-666-0246
Mailing Address - Street 1:105 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-2221
Mailing Address - Country:US
Mailing Address - Phone:501-666-0246
Mailing Address - Fax:501-666-2113
Practice Address - Street 1:1509 MICHAEL DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-2336
Practice Address - Country:US
Practice Address - Phone:501-223-9015
Practice Address - Fax:501-666-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR313M00000X, 315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities