Healthcare Provider Details

I. General information

NPI: 1699055046
Provider Name (Legal Business Name): ARKANSAS FAMILY CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2011
Last Update Date: 08/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 SPRINGDALE DR
ALMA AR
72921-7597
US

IV. Provider business mailing address

PO BOX 1196
ALMA AR
72921-1196
US

V. Phone/Fax

Practice location:
  • Phone: 479-430-4790
  • Fax:
Mailing address:
  • Phone: 479-430-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License NumberR84792
License Number StateAR

VIII. Authorized Official

Name: MRS. TONYA ELAINE WALTERS
Title or Position: CEO / PRESIDENT
Credential: RN
Phone: 479-430-4790