Healthcare Provider Details

I. General information

NPI: 1548185606
Provider Name (Legal Business Name): COMMUNITY TRANSFORMATION CHURCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E HARDING ST
MORRILTON AR
72110-1539
US

IV. Provider business mailing address

PO BOX 1032
MORRILTON AR
72110-1032
US

V. Phone/Fax

Practice location:
  • Phone: 281-743-2713
  • Fax: 281-743-2713
Mailing address:
  • Phone: 281-743-2713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: SPENCER KILGORE
Title or Position: EXECUTIVE PASTOR
Credential: KILGORE
Phone: 281-743-2713