Healthcare Provider Details

I. General information

NPI: 1801664925
Provider Name (Legal Business Name): ARKANSAS COMPLETE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 AVIATION PLZ STE D
HOT SPRINGS AR
71913-5531
US

IV. Provider business mailing address

190 AVIATION PLZ STE D
HOT SPRINGS AR
71913-5531
US

V. Phone/Fax

Practice location:
  • Phone: 501-525-2770
  • Fax:
Mailing address:
  • Phone: 501-525-2770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KRIS ESTELLE BELL
Title or Position: COO
Credential: RT
Phone: 501-525-2770