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General NPI Number Information
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NPI Number | 1568461887
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Entity Type | Organization
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Legal Business Name | OZARK GUIDANCE CENTER, INC
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2400 S 48TH ST
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City | SPRINGDALE
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State | AR
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Zip | 72762-6683
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Country | US
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Telephone | 479-750-2020
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Fax | 479-750-4843
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Provider Business Mailing Address
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Address Line | 2400 S 48TH ST
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City | SPRINGDALE
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State | AR
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Zip | 72762-6683
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Country | US
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Telephone | 479-750-2020
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Fax | 479-751-4346
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | PATRICIA YABLONSKI
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Credential |
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Telephone | 479-725-5140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State | AR
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