Ozark Community Bridge, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

OZARK COMMUNITY BRIDGE, LLC

Doing business as

Ozark Community Bridge, LLC

Practice address

2705 N Club Dr Apt 9
Fayetteville, AR 72703-4757

Phone

(207) 618-3784

NPI assigned

Jan 15, 2022

Last updated

Jan 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Narcisse Mugisha

Title

Ceo

Phone

(207) 618-3784

Specialties & licenses 1

Addresses

Other names 1

• OZARK COMMUNITY BRIDGE, LLC Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1642204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642204800000",
    "number": "1811648371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 N CLUB DR APT 9",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N CLUB DR APT 9",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034757",
            "telephone_number": "207-618-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK COMMUNITY BRIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-15",
        "last_updated": "2022-01-15",
        "certification_date": "2022-01-15",
        "status": "A",
        "authorized_official_last_name": "MUGISHA",
        "authorized_official_first_name": "NARCISSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-618-3784"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Devices",
            "affiliation": "N",
            "endpointDescription": "Electronic Devices",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2705 N Club Dr Apt 9",
            "city": "Fayetteville",
            "state": "AR",
            "country_code": "US",
            "postal_code": "727034757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "OZARK COMMUNITY BRIDGE, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Oxford, APRN
• Ozanne Family Chiropractic (Thrive Wellness Center)
• Benjamin Arn Ozanne, D.C.
• Lucy Ozanne, CCC-SLP
• Ozark Center for Lifestyle Medicine, Inc.
• Ozark Dental Care (Dr Scott Stephens Family and Cosmetic Dentistry)
• Ozark Dermatology Clinic
• Ozark Foot & Ankle PLC
• Ozark Medical Consultants PLLC
• Ozark Mobility Nemt, LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2022; 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.