MEDICARE: OZARK GUIDANCE CENTER, INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609875186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OZARK GUIDANCE CENTER, INC

Provider Business Mailing Address
First Line	:	2400 S 48TH ST
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-6683
Country	:	US
Telephone Number	:	479-750-2020
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 S. 48TH STREET
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762
Country	:	US
Telephone Number	:	479-750-2020
Fax Number	:	479-750-8967

Authorized Official
Title or Position	:	CREDENTIALING SUPERVISOR
Name	:	KELLY BUNCH
Credential	:
Telephone Number	:	479-725-5115

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	03/19/2026

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