Healthcare Provider Details

I. General information

NPI: 1376454546
Provider Name (Legal Business Name): TOBE INTIATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 LOCUST ST
MARIANNA AR
72360-1944
US

IV. Provider business mailing address

PO BOX 1298
WEST MEMPHIS AR
72303-1298
US

V. Phone/Fax

Practice location:
  • Phone: 870-636-5155
  • Fax:
Mailing address:
  • Phone: 870-636-5155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHERESE GREEN
Title or Position: OWNER
Credential:
Phone: 870-514-9383