NPI 1467780510

Madison Residential Care Facility

Organisation Physical Disabilities Residential Treatment Facility Little Rock, AR

Practice location

Address: 2821 W Dixon Rd, Little Rock, AR 72206-4256
Phone: (501) 888-4080
Fax: (501) 486-9119

Authorised official

Name: Sy Niksefat
Title: Owner
Phone: (501) 888-4080

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence 041 (AR)

Other Residential Treatment Facility, Physical Disabilities providers in Arkansas →

Registry record

NPI: 1467780510
Entity type: Organization
NPI issued: 1 Dec 2009
Record last updated: 1 Dec 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.