Healthcare Provider Details

I. General information

NPI: 1841218393
Provider Name (Legal Business Name): SENIOR RESOLUTION RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 EXECUTIVE CENTER DR DANVILLE BUILDING, SUITE 303
LITTLE ROCK AR
72211-4354
US

IV. Provider business mailing address

10810 EXECUTIVE CENTER DR DANVILLE BUILDING, SUITE 303
LITTLE ROCK AR
72211-4354
US

V. Phone/Fax

Practice location:
  • Phone: 501-312-7578
  • Fax: 501-312-7577
Mailing address:
  • Phone: 501-312-7578
  • Fax: 501-312-7577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1948-C
License Number StateAR

VIII. Authorized Official

Name: ANDREA RYANE SOREY
Title or Position: SOCIAL WORKER
Credential: L.C.S.W.
Phone: 501-312-7578