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State of Arkansas

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Arkadelphia, AR

NPI 1407988355 · NPPES record last updated Jun 26, 2008

Key facts

NPI
1407988355
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
320900000X (AR)
Legal business name
STATE OF ARKANSAS
Practice address
1 Prator Drive
Arkadelphia, AR 71923
Phone
(870) 246-8011
Fax
(870) 230-8424
NPI assigned
Mar 9, 2007
Organization subpart
No

Authorized official

Name
Ms. Margaret Green
Title
Superintendent
Phone
(870) 246-8011

Corporate family (same tax ID) 5

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

Practitioners 1

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

National Provider Directory

Tax ID family
Arkansas Dept of Health and Human Services (6 organizations share this tax ID)

Locations

1 Prator Dr
Arkadelphia, AR 71923
Phone (870) 246-8011

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 320900000X AR Yes

Addresses

Primary practice location

1 Prator Drive
Arkadelphia, AR 71923

Mailing address

PO Box 8181
Little Rock, AR 72203-8181
Phone (870) 246-8011

Other identifiers

IdentifierTypeStateIssuer
109055213MedicaidAR

Other names

  • Arkadelphia HDC Doing business as

Other providers in Arkadelphia, AR

All providers in Arkadelphia, AR · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arkansas

Sources for this page

Verify at the official NPI Registry.