Healthcare Provider Details

I. General information

NPI: 1578520508
Provider Name (Legal Business Name): THE ELIZABETH RICHARDSON CTR.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 03/06/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3917 S. OLD MISSOURI RD.
SPRINGDALE AR
72764
US

IV. Provider business mailing address

3917 S. OLD MISSOURI RD.
SPRINGDALE AR
72764
US

V. Phone/Fax

Practice location:
  • Phone: 479-872-1800
  • Fax: 479-872-4654
Mailing address:
  • Phone: 479-872-1800
  • Fax: 479-872-4654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA A TANKERSLEY
Title or Position: BILLING SPECIALIST
Credential:
Phone: 479-872-1800