Healthcare Provider Details

I. General information

NPI: 1255579157
Provider Name (Legal Business Name): UNITED METHODIST BEHAVIORAL HEALTH SYSTEMS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2009
Last Update Date: 01/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 YOUTH RANCH RD
AMITY AR
71921-9602
US

IV. Provider business mailing address

1600 ALDERSGATE RD
LITTLE ROCK AR
72205-6614
US

V. Phone/Fax

Practice location:
  • Phone: 501-661-0720
  • Fax:
Mailing address:
  • Phone: 501-661-0720
  • Fax: 501-325-7938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANDY ALTOM
Title or Position: CEO
Credential:
Phone: 501-661-0720