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General NPI Number Information
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NPI Number | 1376330522
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Entity Type | Organization
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Legal Business Name | 10TH DISTRICT SUBSTANCE ABUSE TREATMENT CENTER
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 1211B HIGHWAY 133 N
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City | CROSSETT
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State | AR
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Zip | 71635-4843
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Country | US
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Telephone | 870-364-1953
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Fax |
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Provider Business Mailing Address
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Address Line | 412 YORK ST
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City | WARREN
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State | AR
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Zip | 71671-3218
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Country | US
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Telephone | 870-226-9955
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Fax |
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Authorized Official
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Title or Position | OM
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Name | SARAH RACKLEY
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Credential |
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Telephone | 479-242-1003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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