Healthcare Provider Details

I. General information

NPI: 1376805515
Provider Name (Legal Business Name): 10TH DISTRICT SUBSTANCE ABUSE TREATMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 WOODLAWN ST
WARREN AR
71671-3050
US

IV. Provider business mailing address

412 YORK ST
WARREN AR
71671-3218
US

V. Phone/Fax

Practice location:
  • Phone: 870-226-9970
  • Fax: 870-226-9972
Mailing address:
  • Phone: 870-226-9970
  • Fax: 870-226-9972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH RACKLEY
Title or Position: OM
Credential:
Phone: 479-242-1003