=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205638699
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARKANSAS CONNECTIONS ACADEMY, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2025
-----------------------------------------------------
Last Update Date | 03/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1009 BEAU TERRE DR BUILDING O
-----------------------------------------------------
City | BENTONVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-662-9358
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1009 BEAU TERRE DR BUILDING O
-----------------------------------------------------
City | BENTONVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF SPECIAL POPULATIONS
-----------------------------------------------------
Name | BETH LEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 479-662-9358
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------