PROVALSD CLARKSVILLE NPI 1811831068

NPI Information

  • NPI: 1811831068
  • Provider Name: PROVALSD CLARKSVILLE
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 702 S HOSPITAL DR
    CLARKSVILLE, AR
    ZIP 72830
  • Phone: (479) 747-6696

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NPI Details

PROVALSD CLARKSVILLE is an assisted living facility in Clarksville, AR. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PROVALSD CLARKSVILLE NPI is 1811831068. The provider is registered as an organization entity type.

The provider's business location address is:

702 S HOSPITAL DR
CLARKSVILLE, AR
ZIP 72830-434
Phone: (479) 747-6696
Fax: (479) 747-6696

The provider's authorized official is Malissa Ellis .
The authorized official title is Director Of Operations and has the following contact phone number (501) 472-9070.

The enumeration date for this NPI number is 4/17/2026 and was last updated on 4/17/2026.

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
1310400000XAssisted Living FacilityYes

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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