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General NPI Number Information
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NPI Number | 1023663630
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Entity Type | Organization
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Legal Business Name | ARKANSAS SUPPORT NETWORK, INC
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 08/09/2019
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Provider Practice Location Address
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Address Line | 6836 ISSACS ORCHARD RD
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City | SPRINGDALE
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State | AR
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Zip | 72762-6096
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Country | US
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Telephone | 479-927-4100
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Fax | 479-927-4101
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Provider Business Mailing Address
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Address Line | 6836 ISSACS ORCHARD RD
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City | SPRINGDALE
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State | AR
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Zip | 72762-6096
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Country | US
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Telephone | 479-927-4100
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Fax | 479-927-4101
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Authorized Official
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Title or Position | CFO/DIRECTOR OF HR
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Name | MR. DANIEL M MARINO
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Credential | CPA
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Telephone | 479-927-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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