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Organization

FRIENDSHIP COMMUNITY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTINA MICHELLE DUNCAN (CREDENTIALING SPECIALIST)
(479) 967-2322
Entity
Organization

Contact information

Practice address
920 UNIVERSITY DR, RUSSELLVILLE, AR 72801-4303
(479) 967-2322
Mailing address
PO BOX 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
261QP2000X
Physical Therapy Clinic/Center
PTA2755
AR
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary

Other

Enumeration date
04/01/2014
Last updated
12/28/2022
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