MEDICARE: SAMARITAN HOUSE COMMUNITY CENTER

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	261Q00000X	Clinic/Center
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1932953809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMARITAN HOUSE COMMUNITY CENTER

Provider Business Mailing Address
First Line	:	PO BOX 939
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72757-0939
Country	:	US
Telephone Number	:	479-636-4198
Fax Number	:

Provider Business Practice Location Address
First Line	:	2910 S 8TH ST
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-1031
Country	:	US
Telephone Number	:	479-636-4198
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DEBBIE K RAMBO
Credential	:
Telephone Number	:	479-636-4198

Provider Enumeration Date	:	04/16/2024
Last Update Date	:	04/16/2024

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Directions to “SAMARITAN HOUSE COMMUNITY CENTER ” Practice Location

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