MEDICARE: THE GUIDANCE CENTER - THE ROCK HOUSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1073788477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GUIDANCE CENTER - THE ROCK HOUSE

Provider Business Mailing Address
First Line	:	PO BOX 11818
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72917-1818
Country	:	US
Telephone Number	:	479-452-6650
Fax Number	:	479-785-9495

Provider Business Practice Location Address
First Line	:	7302 ROGERS AVE
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-4164
Country	:	US
Telephone Number	:	479-452-6650
Fax Number	:	479-785-9495

Authorized Official
Title or Position	:	CEO
Name	:	AARON L. 'RUSTI' HOLWICK
Credential	:
Telephone Number	:	479-452-6650

Provider Enumeration Date	:	04/25/2008
Last Update Date	:	06/06/2024

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