Provider Demographics
NPI:1558640565
Name:LITTLE BITTY CITY THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:LITTLE BITTY CITY THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MSSE
Authorized Official - Phone:501-627-4388
Mailing Address - Street 1:1635 HIGDON FERRY RD
Mailing Address - Street 2:STE C PMB 124
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6913
Mailing Address - Country:US
Mailing Address - Phone:501-525-7529
Mailing Address - Fax:501-525-7531
Practice Address - Street 1:154 CORNERSTONE BLVD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6560
Practice Address - Country:US
Practice Address - Phone:501-525-7529
Practice Address - Fax:501-525-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-08
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARIN23261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR201577742Medicaid
AR187123778Medicaid