OrganizationActive
Youthbridge
NPI 1912314972 · Mental Illness Community Based Residential Treatment Facility · Fayettville, AR
Provider details
- NPI number
- 1912314972
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Marilyn Hoke, Human Resources(479) 575-9471
- License
- 171MOOOOOX (AR)
Specialties & taxonomies
- Mental Illness Community Based Residential Treatment FacilityPrimary320800000XLicense 171MOOOOOX (AR)
Residential Treatment Facilities
Practice location
2153 E Joyce Blvd
Fayettville, AR 72703
Phone: (479) 575-9471
Approximate (ZIP-level) locationGet directions
Mailing address
2153 E Joyce Blvd
Fayetteville, AR 72703-4714
Registry dates
- Enumerated
- 2014-07-22
- Last updated
- 2014-07-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.