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General NPI Number Information
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NPI Number | 1891913885
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Entity Type | Organization
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Legal Business Name | THE ARKANSAS CENTER FOR INDEPENDENCE, INC.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 200 RAY ST
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City | NEWPORT
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State | AR
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Zip | 72112-4232
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Country | US
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Telephone | 870-523-8488
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Fax | 870-523-3646
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Provider Business Mailing Address
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Address Line | 200 RAY ST
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City | NEWPORT
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State | AR
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Zip | 72112-4232
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Country | US
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Telephone | 870-523-8488
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Fax | 870-523-3646
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | GLENDA MOODY
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Credential |
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Telephone | 870-523-8488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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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 | 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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