State of Arkansas

NPI #1023236163 in Warren, Arkansas

Provider Information

NPI Number: 1023236163
Entity Type: Organization
Organization Name: State of Arkansas
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 23, 2007
Last Updated: Oct 24, 2022

Practice Location

Address: 1 CENTER CIR
City: Warren
State: Arkansas
ZIP Code: 71671-3033
Phone: (870) 226-6774

Authorized Official

Name: MR. MARK ALLEN WARGO
Title: DHS DDS SUPERINTENDENT HDC
Phone: (870) 226-6774

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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