Provider Demographics
NPI:1801775416
Name:10TH DISTRICT SUBSTANCE ABUSE TREATMENT CENTER
Entity type:Organization
Organization Name:10TH DISTRICT SUBSTANCE ABUSE TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OM
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RACKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-242-1003
Mailing Address - Street 1:2300 W 29TH AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-5005
Mailing Address - Country:US
Mailing Address - Phone:844-220-9970
Mailing Address - Fax:501-510-5917
Practice Address - Street 1:2300 W 29TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-5005
Practice Address - Country:US
Practice Address - Phone:844-220-9970
Practice Address - Fax:501-510-5917
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:10TH DISTRICT SUBSTANCE ABUSE TREATMENT CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)