Healthcare Provider Details

I. General information

NPI: 1225953797
Provider Name (Legal Business Name): GRADUATE ARKANSAS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6724 INTERSTATE 30
LITTLE ROCK AR
72209-3157
US

IV. Provider business mailing address

6724 INTERSTATE 30
LITTLE ROCK AR
72209-3157
US

V. Phone/Fax

Practice location:
  • Phone: 501-500-9270
  • Fax:
Mailing address:
  • Phone: 501-500-9270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: KERRI MCNEAL
Title or Position: ADMINISTRATOR
Credential:
Phone: 501-404-5674