Healthcare Provider Details

I. General information

NPI: 1164547121
Provider Name (Legal Business Name): DEPARTMENT OF HEALTH AND HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 W TOWNSHIP ST
FAYETTEVILLE AR
72703-2821
US

IV. Provider business mailing address

PO BOX 1437 SLOT H-40
LITTLE ROCK AR
72203-1437
US

V. Phone/Fax

Practice location:
  • Phone: 479-675-2593
  • Fax: 501-675-5852
Mailing address:
  • Phone: 501-661-2859
  • Fax: 501-661-2691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: TERRI S WRIGHT
Title or Position: AGENCY PROGRAM COORDINATOR
Credential: BBA
Phone: 501-661-2859