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General NPI Number Information
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NPI Number | 1780999193
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Entity Type | Organization
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Legal Business Name | SUPPORT SOLUTIONS OF ARKANSAS
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 08/10/2010
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Provider Practice Location Address
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Address Line | 5909 SHELBY OAKS DR STE 100
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City | MEMPHIS
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State | TN
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Zip | 38134-7318
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Country | US
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Telephone | 901-383-9193
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Fax | 901-383-9195
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Provider Business Mailing Address
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Address Line | 818 CANAL ST
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City | MARION
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State | AR
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Zip | 72364-5075
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Country | US
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Telephone | 901-383-9193
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Fax | 901-383-9195
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. LARRY L. DURBIN
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Credential | ED. D.
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Telephone | 901-383-9193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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