NPIMap

Organization Active NPI

The Guidance Center - Mena Clinic

  • Community/Behavioral Health Agency
  • Mena, AR
National Provider Identifier
1356516579
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
THE GUIDANCE CENTER - MENA CLINIC
Practice address
307 Cherry St
Mena, AR 71953-4382
Phone
(479) 452-6650
Fax
(479) 785-9495
NPI assigned
Apr 29, 2008
Last updated
Jun 6, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Aaron L. 'Rusti' HolwickNPI 1164437810
Title
Ceo
Phone
(479) 452-6650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

307 Cherry St
Mena, AR 71953-4382

Mailing address

PO Box 11818
Fort Smith, AR 72917-1818
Phone (479) 452-6650

Other identifiers 1

IdentifierTypeStateIssuer
138596726MedicaidAR

Other names 2

  • WACGC - Mena Clinic Other name
  • WACGC - Polk County Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623001595 AR Part B Supplier - Clinic/Group Practice 1355326174 Receives reassigned benefits from 109 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Booneville, AR; Fort Smith, AR; Mena, AR; Ozark, AR; Paris, AR; Van Buren, AR; Waldron, AR

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Guidance Center - Horizon Renewal Center30 organizations share this tax ID, including this one
Part of
The Guidance Center - Horizon Renewal Center

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1356516579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11818",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729171818",
            "telephone_number": "479-452-6650",
            "fax_number": "479-785-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 CHERRY ST",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534382",
            "telephone_number": "479-452-6650",
            "fax_number": "479-785-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE GUIDANCE CENTER - MENA CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC",
        "enumeration_date": "2008-04-29",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "HOLWICK",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "L. 'RUSTI'",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "479-452-6650"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138596726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WACGC - Mena Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WACGC - Polk County Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mena, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.