Provider Demographics
NPI:1538102223
Name:BIRCH TREE COMMUNITIES, INC.
Entity Type:Organization
Organization Name:BIRCH TREE COMMUNITIES, INC.
Other - Org Name:ARKANSAS HEALTH CENTER BRANCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:N
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:VP
Authorized Official - Phone:501-315-3344
Mailing Address - Street 1:PO BOX 1589
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-1589
Mailing Address - Country:US
Mailing Address - Phone:501-315-3344
Mailing Address - Fax:
Practice Address - Street 1:6701 HWY 67 S
Practice Address - Street 2:BLDG 4
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015
Practice Address - Country:US
Practice Address - Phone:501-315-3344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR116374726Medicaid
AR116374726Medicaid