Organization
THE GREGORY KISTLER TREATMENT CENTER, INC.
Active
Organization
THE GREGORY KISTLER TREATMENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER KISTLER (EXECUTIVE DIRECTOR)
(479) 785-4677
Entity
Organization
Contact information
Practice address
3304 S M ST, FORT SMITH, AR 72903-2903
(479) 785-4677
(479) 785-4673
Mailing address
3304 S M ST, FORT SMITH, AR 72903-2903
(479) 785-4677
(479) 785-4673
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188778767
—
AR
05
—
188779771
—
AR
05
—
188780782
—
AR
Enumeration date
02/13/2020
Last updated
03/04/2020
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