RESTAURA ARKANSAS LLC NPI 1104663889

NPI Information

  • NPI: 1104663889
  • Provider Name: RESTAURA ARKANSAS LLC
  • Classification: Clinic/Center - 261QR0405X
  • Specialization: Rehabilitation, Substance Use Disorder
  • Entity Type: Organization
  • :
  • CLIA Number: 04D2310595
  • Address: 1301 RIDGWAY RD STE 1C
    PINE BLUFF, AR
    ZIP 71603
  • Phone: (870) 395-7341

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NPI Details

RESTAURA ARKANSAS LLC is a rehabilitation and substance use disorder clinic center in Pine Bluff, AR. RESTAURA ARKANSAS LLC NPI is 1104663889. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1301 RIDGWAY RD STE 1C
PINE BLUFF, AR
ZIP 71603-610
Phone: (870) 395-7341

The provider's authorized official is Kimberly Brown .
The authorized official title is Executive Director and has the following contact phone number (870) 243-7219.

The CLIA number assigned to this NPI record is 04D2310595 - other - office based opioid treat with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/10/2024 and was last updated on 5/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QR0405XClinic/CenterRehabilitation, Substance Use DisorderYes

What is NPI?

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This page was last updated on: 11/21/2025

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