Healthcare Provider Details

I. General information

NPI: 1720992837
Provider Name (Legal Business Name): TEEN ACTION AND SUPPORT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W NEW HOPE RD
ROGERS AR
72758-1351
US

IV. Provider business mailing address

2525 W NEW HOPE RD
ROGERS AR
72758-1351
US

V. Phone/Fax

Practice location:
  • Phone: 479-636-8272
  • Fax: 479-636-8276
Mailing address:
  • Phone: 479-636-8272
  • Fax: 479-636-8276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAWN SPRAGG
Title or Position: CEO
Credential: LPC
Phone: 479-636-8272