| Organization Name: | STATE OF ARKANSAS |
| NPI Number: | 1134252414 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAWN GRAZIANI (DIRECTOR) |
| Mailing Address: | 5800 W 10th St Suite 300 Little Rock |
| State: | AR US |
| Postal Code: | 722041752 |
| Phone Number: | 5016612873 |
| Fax Number: | 5012804619 |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |