Provider Demographics
NPI:1699482281
Name:CENTRAL ARKANSAS TESTING & THERAPY CENTER
Entity type:Organization
Organization Name:CENTRAL ARKANSAS TESTING & THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIES
Authorized Official - Suffix:
Authorized Official - Credentials:LPE-I
Authorized Official - Phone:501-764-3002
Mailing Address - Street 1:2850 PRINCE ST STE 53
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-3600
Mailing Address - Country:US
Mailing Address - Phone:501-764-3002
Mailing Address - Fax:866-514-7628
Practice Address - Street 1:2850 PRINCE ST STE 53
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-3600
Practice Address - Country:US
Practice Address - Phone:501-764-3002
Practice Address - Fax:866-514-7628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1322-EIOtherLICENSE