IndividualActive
Derwin Clark
NPI 1508231085 · Emotionally Disturbed Childrens' Residential Treatment Facility · Little Rock, AR
Provider details
- NPI number
- 1508231085
- Entity type
- Individual
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
20400 Colonel Glenn Rd
Little Rock, AR 72210-5323
Phone: (501) 821-5500
Fax: (501) 821-5580
Approximate (ZIP-level) locationGet directions
Mailing address
20400 Colonel Glenn Rd
Little Rock, AR 72210-5323
Registry dates
- Enumerated
- 2015-12-09
- Last updated
- 2015-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.