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Organization

STATE OF ARKANSAS

Active
Other names
In Home Services MIP
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DAWN GRAZIANI (DIRECTOR)
(501) 661-2154
Entity
Organization

Contact information

Practice address
5800 W 10TH ST, SUITE 300, LITTLE ROCK, AR 72204-1752
(501) 661-2873
(501) 280-4619
Mailing address
MATERNAL INFANT SLOT H5, PO BOX 1437, LITTLE ROCK, AR 72203-1437
(501) 661-2873
(501) 280-4619

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary

Other

Enumeration date
03/14/2007
Last updated
08/22/2020
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