# STATE OF ARKANSAS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Conway Human Development Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093840282
- **Authorized official:** SALLY SELLERS (BUSINESS OPERATIONS MANAGER)
- **Authorized official phone:** (501) 329-6851

## Contact information

- **Practice address:** 150 SIEBENMORGEN RD, CONWAY, AR 72032
- **Practice address phone:** (501) 329-6851
- **Practice address fax:** (501) 336-0508
- **Mailing address:** 150 SIEBENMORGEN RD, CONWAY, AR 72032
- **Mailing address phone:** (501) 329-6851
- **Mailing address fax:** (501) 336-0508

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 139 | AR | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 08/24/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 109217213 | — | AR |