Provider Demographics
NPI:1346384724
Name:ARKANSAS THERAPY GROUP, INC.
Entity Type:Organization
Organization Name:ARKANSAS THERAPY GROUP, INC.
Other - Org Name:ARKANSAS THERAPY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:LA COMFORA
Authorized Official - Suffix:
Authorized Official - Credentials:CCC / SLP
Authorized Official - Phone:501-625-7800
Mailing Address - Street 1:100 GREENWOOD AVENUE
Mailing Address - Street 2:SUITE D
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-4441
Mailing Address - Country:US
Mailing Address - Phone:501-625-7800
Mailing Address - Fax:501-325-2727
Practice Address - Street 1:100 GREENWOOD AVENUE
Practice Address - Street 2:SUITE D
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4441
Practice Address - Country:US
Practice Address - Phone:501-625-7800
Practice Address - Fax:501-325-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-18
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225100000X, 225X00000X, 231H00000X, 235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR156339742Medicaid