Provider Demographics
NPI:1982049276
Name:LITTLE ROCK RECOVERY OUTREACH
Entity Type:Organization
Organization Name:LITTLE ROCK RECOVERY OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LCSW
Authorized Official - Phone:501-454-4354
Mailing Address - Street 1:6705 W 12TH ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-1515
Mailing Address - Country:US
Mailing Address - Phone:501-265-0255
Mailing Address - Fax:501-265-0225
Practice Address - Street 1:6705 W 12TH ST
Practice Address - Street 2:SUITE 7
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-1515
Practice Address - Country:US
Practice Address - Phone:501-265-0255
Practice Address - Fax:501-265-0225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health