Healthcare Provider Details

I. General information

NPI: 1669907408
Provider Name (Legal Business Name): AWARENESS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S PINE ST
LITTLE ROCK AR
72204-2073
US

IV. Provider business mailing address

900 S PINE ST
LITTLE ROCK AR
72204-2073
US

V. Phone/Fax

Practice location:
  • Phone: 501-612-4406
  • Fax:
Mailing address:
  • Phone: 501-612-4406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number300155
License Number StateAR

VIII. Authorized Official

Name: MISS ANTONETTE WILLIAMS
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 501-681-3509