Provider Demographics
NPI:1730787037
Name:THE GUIDANCE CENTER - PRIMARY CARE CLINIC
Entity type:Organization
Organization Name:THE GUIDANCE CENTER - PRIMARY CARE CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:L 'RUSTI'
Authorized Official - Last Name:HOLWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-452-6650
Mailing Address - Street 1:PO BOX 11818
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-1818
Mailing Address - Country:US
Mailing Address - Phone:479-452-6650
Mailing Address - Fax:479-452-5847
Practice Address - Street 1:3117 S 70TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5017
Practice Address - Country:US
Practice Address - Phone:479-452-6650
Practice Address - Fax:479-452-5847
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTERN ARKANSAS COUNSELING & GUIDANCE CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-10-09
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty