Provider Demographics
NPI:1588233555
Name:ARKANSAS TREATMENT ASSOCIATES
Entity Type:Organization
Organization Name:ARKANSAS TREATMENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARGILL
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:405-922-7750
Mailing Address - Street 1:7136 S YALE AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6381
Mailing Address - Country:US
Mailing Address - Phone:140-592-2775
Mailing Address - Fax:
Practice Address - Street 1:227 N GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-3451
Practice Address - Country:US
Practice Address - Phone:479-763-1031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health