Healthcare Provider Details

I. General information

NPI: 1609985563
Provider Name (Legal Business Name): CENTRAL ARKANSAS VETERANS HEALTH CARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DR TOWBIN HEALTH CENTER, STS (116E/NLR)
NORTH LITTLE ROCK AR
72114-1709
US

IV. Provider business mailing address

2200 FORT ROOTS DR TOWBIN HEALTH CENTER, STS (116E/NLR)
NORTH LITTLE ROCK AR
72114-1709
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-3204
  • Fax:
Mailing address:
  • Phone: 501-257-3204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1455
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN J STEVENSON
Title or Position: ADDICTION THERAPIST/PRG COORDINATOR
Credential: B.SC.
Phone: 501-257-3204