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NPI Code Detail

MEDICARE: NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC

MEDICARE: NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336118207
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC
Provider Business Mailing Address
First Line : 2707 BROWNS LN
Second Line :
City : JONESBORO
State : AR
Zip : 72401-7213
Country : US
Telephone Number : 870-972-4000
Fax Number : 970-972-4911
Provider Business Practice Location Address
First Line : 2707 BROWNS LN
Second Line :
City : JONESBORO
State : AR
Zip : 72401-7213
Country : US
Telephone Number : 870-972-4000
Fax Number : 970-972-4911
Authorized Official
Title or Position : ASSISTANT EXECUTIVE DIRECTOR
Name : STEPHEN JOHNSON
Credential :
Telephone Number : 870-972-4000
Provider Enumeration Date : 03/14/2006
Last Update Date : 04/22/2022

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Directions to “NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC ” Practice Location

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