9621 Tall Timber LLC
Community/Behavioral Health in Little Rock, AR. Organization (NPI-2).
NPI number1902711690
StatusActive
Last updated in NPPESAug 17, 2026
Details
- NPI
- 1902711690
- Entity type
- Organization (NPI-2)
- Legal business name
- 9621 Tall Timber LLC
- Organization subpart
- No
- Enumeration date
- Aug 17, 2026
- Certification date
- Aug 17, 2026
- Last updated
- Aug 17, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Other names
- Gardens Of Brodie Creek (Doing Business As)
Practice location
9621 Tall Timber BlvdLittle Rock, AR 72204-8592
Phone 501-224-0846 · Fax 501-224-0834
Mailing address
10 Shackleford Plz Ste 102Little Rock, AR 72211-1886
Phone 501-224-0846 · Fax 501-224-0834
Authorized official
Georgia Johnston
President
5012240846
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