Organization
PROVALSD CLARKSVILLE
Active
Other names
Providence Assisted Living Clarksville
Organization subpart
No
Provider details
NPI number
Authorized official
MALISSA ELLIS ELLIS (DIRECTOR OF OPERATIONS)
(501) 472-9070
Entity
Organization
Contact information
Practice address
702 S HOSPITAL DR, CLARKSVILLE, AR 72830-4434
(479) 747-6696
(479) 747-6696
Mailing address
702 S HOSPITAL DR, CLARKSVILLE, AR 72830-4434
(479) 747-6696
(479) 747-6696
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/17/2026
Last updated
04/17/2026
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