HABILITATION CENTER LLC NPI 1659135358

NPI Information

  • NPI: 1659135358
  • Provider Name: HABILITATION CENTER, LLC
  • Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
  • Entity Type: Organization
  • Doing Business As: MILLCREEK OF ARKANSAS
  • CLIA Number: 04D1027329
  • Address: 1828 INDUSTRIAL DR
    FORDYCE, AR
    ZIP 71742
  • Phone: (870) 352-8203

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NPI Details

HABILITATION CENTER, LLC is an intermediate care facility mentally retarded in Fordyce, AR. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. HABILITATION CENTER, LLC NPI is 1659135358. The provider is registered as an organization entity type.
The provider Is Doing Business As Millcreek Of Arkansas.

The provider's business location address is:

1828 INDUSTRIAL DR
FORDYCE, AR
ZIP 71742-110
Phone: (870) 352-8203
Fax: (870) 352-5311

The provider's authorized official is Brian Phillip Farley .
The authorized official title is Vice President & Secretary and has the following contact phone number (615) 861-6000.

The CLIA number assigned to this NPI record is 04D1027329 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/13/2024 and was last updated on 5/23/2024.

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
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

What is NPI?

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

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