Healthcare Provider Details

I. General information

NPI: 1841810231
Provider Name (Legal Business Name): PROSPERITY HANDS MINISTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2020
Last Update Date: 04/26/2020
Certification Date: 04/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 SW STERLING PL
BENTONVILLE AR
72712-7773
US

IV. Provider business mailing address

710 SW STERLING PL
BENTONVILLE AR
72712-7773
US

V. Phone/Fax

Practice location:
  • Phone: 470-439-9767
  • Fax:
Mailing address:
  • Phone: 470-439-9767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT G JONES
Title or Position: CEO PASTOR
Credential: COUNSELOR
Phone: 470-439-9767