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General NPI Number Information
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NPI Number | 1437557899
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Entity Type | Organization
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Legal Business Name | SPRINGDALE TREATMENT CENTER, LLC
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 1607 S OLD MISSOURI RD
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City | SPRINGDALE
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State | AR
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Zip | 72764-5723
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Country | US
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Telephone | 479-306-4480
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Fax | 479-306-4488
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Provider Business Mailing Address
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Address Line | 1720 LAKEPOINTE DR STE 117
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City | LEWISVILLE
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State | TX
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Zip | 75057-6425
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Country | US
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Telephone | 214-379-3300
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Fax |
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Authorized Official
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Title or Position | VP, TREASURER
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Name | BRUCE JARVIE
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Credential |
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Telephone | 214-379-3300
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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 | 00167
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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