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General NPI Number Information
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NPI Number | 1952482036
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Entity Type | Organization
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Legal Business Name | HABILITATION CENTER, LLC
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 1828 INDUSTRIAL DR
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City | FORDYCE
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State | AR
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Zip | 71742
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Country | US
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Telephone | 870-352-8203
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Fax | 870-352-5277
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Provider Business Mailing Address
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Address Line | 6100 TOWER CIR STE 1000
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City | FRANKLIN
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State | TN
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Zip | 37067-1509
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Country | US
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Telephone | 615-861-6000
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Fax |
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Authorized Official
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Title or Position | VP & SECRETARY
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Name | MR. BRIAN P. FARLEY
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Credential |
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Telephone | 615-861-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 422
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 233
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License Number State | AR
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