STATE OF ARKANSAS (NPI# 1407988355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407988355 |
| Entity Type | Organization |
| Organization Name | STATE OF ARKANSAS |
| Other Organization Name | ARKADELPHIA HDC |
| Practice Address |
1 Prator Drive Arkadelphia AR 71923 |
| Mailing Address |
Po Box 8181 Little Rock AR 72203-8181 |
| Practice Telephone | 8702468011 |
| Practice Fax Number | 8702308424 |
| Mailing Telephone | 8702468011 |
| Mailing Fax Number | 8702308424 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2008-06-26 |
| Authorized Official Name | MS. MARGARET GREEN (SUPERINTENDENT) |
| Authorized Official Telephone | 8702468011 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 320900000X | AR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 109055213 | 05 |
| Other Name | Type Code |
|---|---|
| Arkadelphia HDC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
| 1023236163 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Center Cir, Warren, AR 71671-3033 | 2007-04-23 |
| 1477672608 | State of Arkansas | Case Management | 5800 W 10th St Ste 300, Arkansas Dhhs, Little Rock, AR 72204-1764 | 2007-03-28 |
| 1801928627 | State of Arkansas | Intermediate Care Facility, Mentally Retarded | 87 Reed Rd, Highway 116 South, Booneville, AR 72927 | 2007-03-09 |
| 1487781027 | State of Arkansas | Intermediate Care Facility, Mentally Retarded | 14701 Highway 111, Alexander, AR 72002-1742 | 2007-02-28 |
| 1386770030 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4701 Colony Dr, Jonesboro, AR 72404-9317 | 2007-02-26 |
| 1093840282 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 150 Siebenmorgen Rd, Conway, AR 72032 | 2007-02-21 |
| 1417052895 | State of Arkansas | Skilled Nursing Facility | 1179 N. College Avenue, Fayetteville, AR 72703 | 2006-09-13 |
| 1912014192 | State of Arkansas | Home Health | # 22 Sherwood Plaza, Johnson County Health Unit, Clarksville, AR 72830-4337 | 2006-08-24 |
| 1649280694 | State of Arkansas | Home Health | 100 E 20th, Suite E & F Hempstead County Health Unit, Hope, AR 71801-8213 | 2006-08-09 |
| Street Address |
1 PRATOR DRIVE |
| City | ARKADELPHIA |
| State | AR |
| Zip Code | 71923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467053512 | Lacey Griffin | Pharmacist | 109 Wp Malone Drive, Arkadelphia, AR 71923 | 2020-11-05 |
| 1528478955 | Baptist Health | Clinic/Center | 10 Montgomery Drive, Caddo Valley, AR 71923 | 2014-05-07 |
| 1770923724 | Amber Dawn Jones | Nurse Practitioner | 10 Montgomery Dr, Caddo Valley, AR 71923 | 2013-07-04 |
| 1699050872 | Timothy R Phelan | Pharmacist | 131 N 26 St, Walgreens, Arkadelphia, AR 71923 | 2011-10-19 |
| 1083924229 | Misty Cox | Health Educator | 2410 Pine Street, Arkadelphia, AR 71923 | 2010-10-20 |
| 1942433677 | James W. Hankins, D.d.s., P.a. | Dentist | 2840 Twin Rivers Dr., Arkadelphia, AR 71923 | 2009-08-28 |
| 1003027061 | William Coke Viser | Counselor | 94 Pinnacle Drive, Arkadelphia, AR 71923 | 2007-05-24 |
| 1184843773 | Renski Davis-buckley | Case Manager/Care Coordinator | 524 N. Clark, Arkadelphia, AR 71923 | 2007-04-24 |
| 1003945734 | Danita Stubbs | Case Manager/Care Coordinator | 2607 Caddo Street, Arkadelphia, AR 71923 | 2007-03-06 |
| 1447330659 | Community Vision Center Mossco Inc Dr Randy Wayne Moss Od | Optometrist | 109 Wp Malone, Arkadelphia, AR 71923 | 2006-10-16 |
| Find all providers in zip 71923 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750907374 | Childrens Learning Team | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3700 Kristi Lake Dr Apt D11, Jonesboro, AR 72404-8373 | 2020-06-19 |
| 1710508106 | Abe's Care of Arkansas Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24524 Irish Dr, Hensley, AR 72065-9129 | 2020-04-27 |
| 1891913885 | The Arkansas Center for Independence, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8149 Curtner, Newport, AR 72112-0785 | 2007-04-23 |
| 1013146786 | Easter Seals Arkansas | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3920 Woodland Heights Rd, Little Rock, AR 72212-2495 | 2009-07-02 |
| 1912964305 | Pathfinder, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2520 W Main St, Jacksonville, AR 72076-4214 | 2006-04-28 |
| City | ARKADELPHIA |
| Zip Code | 71923 |
Please comment or provide details below to improve the information on STATE OF ARKANSAS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.