Healthcare Provider Details

I. General information

NPI: 1528693850
Provider Name (Legal Business Name): INCURA OF LITTLE ROCK PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3809 MCCAIN PARK DR STE 110
NORTH LITTLE ROCK AR
72116-7803
US

IV. Provider business mailing address

3809 MCCAIN PARK DR STE 110
NORTH LITTLE ROCK AR
72116-7803
US

V. Phone/Fax

Practice location:
  • Phone: 501-747-1731
  • Fax: 501-897-8321
Mailing address:
  • Phone: 501-747-1731
  • Fax: 501-897-8321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: SETH KLEINBECK
Title or Position: DIRECTOR
Credential: MD
Phone: 501-747-1731