Healthcare Provider Details

I. General information

NPI: 1659424901
Provider Name (Legal Business Name): HOUSING OPPORTUNITIES ADDITION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 COUNTY AVE
TEXARKANA AR
71854-1410
US

IV. Provider business mailing address

4600 COUNTY AVE
TEXARKANA AR
71854-1410
US

V. Phone/Fax

Practice location:
  • Phone: 903-791-2283
  • Fax: 870-774-2853
Mailing address:
  • Phone: 903-791-2283
  • Fax: 870-774-2853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number469
License Number StateAR

VIII. Authorized Official

Name: MRS. PATTY SMITH
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 903-791-2270