Healthcare Provider Details
I. General information
NPI: 1205454808
Provider Name (Legal Business Name): INCURA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2020
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 S RODNEY PARHAM RD
LITTLE ROCK AR
72204-2476
US
IV. Provider business mailing address
1000 S RODNEY PARHAM RD
LITTLE ROCK AR
72204-2476
US
V. Phone/Fax
- Phone: 501-747-1731
- Fax: 501-897-6195
- Phone: 501-747-1731
- Fax: 501-897-6195
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0401X |
| Taxonomy | Comprehensive Outpatient Rehabilitation Facility (CORF) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GRANT
LEE
Title or Position: ADMINISTRATOR
Credential:
Phone: 870-672-1038