NPIMap

Organization Active NPI

Recovery Centers of Arkansas, Inc.

  • Substance Abuse Rehabilitation Facility
  • Little Rock, AR
National Provider Identifier
1831816206
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
RECOVERY CENTERS OF ARKANSAS, INC.
Practice address
6301 Father Tribou St
Little Rock, AR 72205-3003
Phone
(501) 372-4611
Fax
(501) 372-1801
NPI assigned
Oct 25, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
RECOVERY CENTERS OF ARKANSAS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
David Bradshaw, LCSWNPI 1841327749
Title
Executive Director
Phone
(501) 614-4900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

6301 Father Tribou St
Little Rock, AR 72205-3003

Mailing address

9219 Sibley Hole Rd
Little Rock, AR 72209-8874
Phone (501) 614-4900

Other identifiers 1

IdentifierTypeStateIssuer
239221526MedicaidAR

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2066743Recovery Centers of Arkansas - Williamsburg6301 Father Tribou, Little Rock, AR 72205Certificate of waiverOct 2, 2027

National Provider Directory

National Provider Directory
Tax ID family
Recovery Centers of Arkansas Inc3 organizations share this tax ID, including this one
Part of
Recovery Centers of Arkansas Inc

Other organizations with this tax ID 2

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

Locations

6301 Father Tribou St
Little Rock, AR 72205
Phone (501) 319-7623

9219 Sibley Hole Rd
Little Rock, AR 72209
Phone (501) 565-8501

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1831816206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9219 SIBLEY HOLE RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722098874",
            "telephone_number": "501-614-4900",
            "fax_number": "501-372-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 FATHER TRIBOU ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722053003",
            "telephone_number": "501-372-4611",
            "fax_number": "501-372-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY CENTERS OF ARKANSAS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RECOVERY CENTERS OF ARKANSAS, INC.",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "501-614-4900",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "239221526",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.