Healthcare Provider Details

I. General information

NPI: 1548466394
Provider Name (Legal Business Name): THE ARC OF THE OZARKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 01/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S WALL ST
MOUNTAIN GROVE MO
65711-1768
US

IV. Provider business mailing address

1501 E PYTHIAN ST
SPRINGFIELD MO
65802-2139
US

V. Phone/Fax

Practice location:
  • Phone: 417-926-1430
  • Fax:
Mailing address:
  • Phone: 417-864-7887
  • Fax: 417-864-4307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL POWERS
Title or Position: PRESIDENT/CEO
Credential:
Phone: 417-864-7887