Healthcare Provider Details
I. General information
NPI: 1851503460
Provider Name (Legal Business Name): ARCHILD, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7723 COLONEL GLENN RD
LITTLE ROCK AR
72204
US
IV. Provider business mailing address
7723 COLONEL GLENN RD
LITTLE ROCK AR
72204
US
V. Phone/Fax
- Phone: 501-280-9195
- Fax: 501-664-2488
- Phone: 501-280-9195
- Fax: 501-664-2488
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320800000X |
| Taxonomy | Mental Illness Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
MARTI
DUSH
Title or Position: DIRECTOR
Credential: DIRECTOR
Phone: 501-280-9195