Healthcare Provider Details

I. General information

NPI: 1275476186
Provider Name (Legal Business Name): RE-ENGAGE PSYCHIATRY AND RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W CAPITOL AVE SUITE 1700
LITTLE ROCK AR
72201-3438
US

IV. Provider business mailing address

13008 AVILLA HILLS CV
ALEXANDER AR
72002-8074
US

V. Phone/Fax

Practice location:
  • Phone: 501-353-7110
  • Fax:
Mailing address:
  • Phone: 501-353-7110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARY BANKS
Title or Position: NP, PMHNP-C
Credential: APRN
Phone: 501-353-7110