=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063711901
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARKANSAS COMPLETE CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2011
-----------------------------------------------------
Last Update Date | 07/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 190 AVIATION PLZ STE A-C
-----------------------------------------------------
City | HOT SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71913-5529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-525-2770
-----------------------------------------------------
Fax | 501-781-2234
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 190 AVIATION PLZ STE D
-----------------------------------------------------
City | HOT SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71913-5531
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-252-7705
-----------------------------------------------------
Fax | 501-232-2000
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | MRS. KRIS E BELL-HICKS
-----------------------------------------------------
Credential | RT
-----------------------------------------------------
Telephone | 501-525-2770
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0401X
-----------------------------------------------------
Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------