State of Arkansas

NPI #1093840282 in Conway, Arkansas

Provider Information

NPI Number: 1093840282
Entity Type: Organization
Organization Name: State of Arkansas
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 21, 2007
Last Updated: Aug 24, 2023

Practice Location

Address: 150 SIEBENMORGEN RD
City: Conway
State: Arkansas
ZIP Code: 72032
Phone: (501) 329-6851

Authorized Official

Name: SALLY SELLERS
Title: BUSINESS OPERATIONS MANAGER
Phone: (501) 329-6851

Specialties & Taxonomy Codes

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

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