Healthcare Provider Details

I. General information

NPI: 1265627616
Provider Name (Legal Business Name): HEALTHY CONNECTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 01/19/2020
Certification Date: 01/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 LUZERNE ST
MOUNT IDA AR
71957-9449
US

IV. Provider business mailing address

PO BOX 1848
MENA AR
71953-1841
US

V. Phone/Fax

Practice location:
  • Phone: 870-867-4244
  • Fax: 870-867-4254
Mailing address:
  • Phone: 479-437-3449
  • Fax: 479-437-3708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY CALANDRO
Title or Position: CEO
Credential:
Phone: 479-437-3449