Organization
TEXARKANA BEHAVIORAL ASSOCIATES LC
Active
Other names
VISTA HEALTH
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN P. FARLEY (VICE PRESIDENT & SECRETARY)
(615) 861-6000
Entity
Organization
Contact information
Practice address
2003 SE WALTON BLVD, BENTONVILLE, AR 72712-3725
(479) 464-8081
(479) 464-0674
Mailing address
4253 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4593
(479) 521-5731
(579) 521-4926
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152352726
—
AR
Enumeration date
03/05/2007
Last updated
08/27/2023
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