NPIMap

Organization Active NPI

Texarkana Behavioral Associates LC

  • Developmentally Disabled Services Day Training Agency
  • Bentonville, AR
National Provider Identifier
1386773554
Registry record updated Aug 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
TEXARKANA BEHAVIORAL ASSOCIATES LC
Practice address
2003 SE Walton Blvd
Bentonville, AR 72712-3725
Phone
(479) 464-8081
Fax
(479) 464-0674
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2023

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

Authorized official

Name
Brian P. Farley
Title
Vice President & Secretary
Phone
(615) 861-6000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

2003 SE Walton Blvd
Bentonville, AR 72712-3725

Mailing address

4253 N Crossover Rd
Fayetteville, AR 72703-4593
Phone (479) 521-5731

Other identifiers 1

IdentifierTypeStateIssuer
152352726MedicaidAR

Other names 1

  • VISTA HEALTH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Vista Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

2003 SE Walton Blvd
Bentonville, AR 72712
Phone (479) 464-5925

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693094400000",
    "number": "1386773554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4253 N CROSSOVER RD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034593",
            "telephone_number": "479-521-5731",
            "fax_number": "579-521-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 SE WALTON BLVD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123725",
            "telephone_number": "479-464-8081",
            "fax_number": "479-464-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXARKANA BEHAVIORAL ASSOCIATES LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2023-08-27",
        "certification_date": "2023-08-27",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152352726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISTA HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VISTA HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.