VIVACITY 360 HEALTH CO NPI 1144135625

NPI Information

  • NPI: 1144135625
  • Provider Name: VIVACITY 360 HEALTH CO
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 116 N LIVERMORE ST
    HAZEN, AR
    ZIP 72064
  • Phone: (501) 232-1107

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NPI Details

VIVACITY 360 HEALTH CO is a primary care clinic center in Hazen, AR. VIVACITY 360 HEALTH CO NPI is 1144135625. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

116 N LIVERMORE ST
HAZEN, AR
ZIP 72064
Phone: (501) 232-1107
Fax: (501) 426-8339

The provider's authorized official is Candice Ann Forte .
The authorized official title is Ceo and has the following contact phone number (501) 954-0443.

The enumeration date for this NPI number is 8/18/2026 and was last updated on 8/18/2026.

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
1207Q00000XFamily MedicineNo
2261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

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

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