Healthcare Provider Details
I. General information
NPI: 1871392712
Provider Name (Legal Business Name): GAIN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6022 ARBOR CV
LITTLE ROCK AR
72209-2702
US
IV. Provider business mailing address
712 W 3RD ST STE 100
LITTLE ROCK AR
72201-2221
US
V. Phone/Fax
- Phone: 501-379-4246
- Fax:
- Phone: 501-379-4246
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HAYLEY
HOGUE
Title or Position: CLINICAL DIRECTOR
Credential: LPC
Phone: 501-379-4246