Healthcare Provider Details

I. General information

NPI: 1053509125
Provider Name (Legal Business Name): CENTRAL ARKANSAS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2007
Last Update Date: 01/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 RIVER RIDGE RD
LITTLE ROCK AR
72227-1525
US

IV. Provider business mailing address

65 RIVER RIDGE RD
LITTLE ROCK AR
72227-1525
US

V. Phone/Fax

Practice location:
  • Phone: 501-837-0028
  • Fax:
Mailing address:
  • Phone: 501-837-0028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberOTR1275
License Number StateAR

VIII. Authorized Official

Name: MRS. KAY WILCOX SMITH
Title or Position: PRESIDENT
Credential: OTR
Phone: 501-837-0028