Healthcare Provider Details

I. General information

NPI: 1013825496
Provider Name (Legal Business Name): ARTRA COMMUNITY SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 LABETTE CT
LITTLE ROCK AR
72205-6807
US

IV. Provider business mailing address

12 LABETTE CT
LITTLE ROCK AR
72205-6807
US

V. Phone/Fax

Practice location:
  • Phone: 501-644-1266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARTERREON RANDLE
Title or Position: OWNER
Credential:
Phone: 501-644-1266