Organization
ACTIVE HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY ROBERTS OTR/L (PRESIDENT)
(479) 659-2342
Entity
Organization
Contact information
Practice address
2220 S WALDRON RD, FORT SMITH, AR 72903-3733
(479) 659-2342
Mailing address
2220 S WALDRON RD, FORT SMITH, AR 72903-3733
(479) 659-2342
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTR1495
LICENSE
AR
Enumeration date
02/27/2019
Last updated
02/27/2019
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