Healthcare Provider Details

I. General information

NPI: 1609718899
Provider Name (Legal Business Name): OUTCOMES ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW BROAD ST
HOXIE AR
72433-2419
US

IV. Provider business mailing address

1600 SW BROAD ST
HOXIE AR
72433-2419
US

V. Phone/Fax

Practice location:
  • Phone: 870-637-1800
  • Fax: 877-447-5311
Mailing address:
  • Phone: 870-558-9234
  • Fax: 877-447-5311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: JEREMY EDWARD ELLIS
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 870-637-1800