Healthcare Provider Details

I. General information

NPI: 1649113952
Provider Name (Legal Business Name): 1232 STULTZ ROAD OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2026
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1232 W STULTZ RD
SPRINGDALE AR
72764-7911
US

IV. Provider business mailing address

2558 E MISSION BLVD
FAYETTEVILLE AR
72703-3298
US

V. Phone/Fax

Practice location:
  • Phone: 479-619-7761
  • Fax: 479-454-4956
Mailing address:
  • Phone: 479-619-7761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARONICA REED
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 479-619-7761