Healthcare Provider Details

I. General information

NPI: 1962399204
Provider Name (Legal Business Name): THE ARC OF THE OZARKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 S FORT AVE STE B
SPRINGFIELD MO
65807-4217
US

IV. Provider business mailing address

2864 S NETTLETON AVE
SPRINGFIELD MO
65807-5970
US

V. Phone/Fax

Practice location:
  • Phone: 417-605-7100
  • Fax: 417-708-0889
Mailing address:
  • Phone: 417-605-7100
  • Fax: 417-708-0889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MELANIE LORA STINNETT
Title or Position: VP OF THERAPY SERVICES
Credential:
Phone: 417-324-7607