Healthcare Provider Details

I. General information

NPI: 1750531745
Provider Name (Legal Business Name): BIRCH TREE COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 09/02/2025
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N 1ST ST
OXFORD AR
72565-9038
US

IV. Provider business mailing address

PO BOX 1589
BENTON AR
72018-1589
US

V. Phone/Fax

Practice location:
  • Phone: 501-315-3344
  • Fax:
Mailing address:
  • Phone: 501-315-3344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PRISCILLA TRUDELL
Title or Position: HEALTH INFORMATION DIRECTOR
Credential:
Phone: 501-303-3115