Organization
CATHOLIC HEALTH INITIATIVES -ST. VINCENT INTERFAITH CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KITTIE A AARON (EXECUTIVE DIRECTOR)
(501) 932-0559
Entity
Organization
Contact information
Practice address
830 N CREEK DR, CONWAY, AR 72032-4711
(501) 932-0559
(501) 932-0227
Mailing address
830 N CREEK DR, CONWAY, AR 72032-4711
(501) 932-0559
(501) 932-0227
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510001631
—
AR
Enumeration date
07/18/2006
Last updated
06/15/2015
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