Healthcare Provider Details

I. General information

NPI: 1023598828
Provider Name (Legal Business Name): NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 GAP RD
BATESVILLE AR
72501-8679
US

IV. Provider business mailing address

2707 BROWNS LN
JONESBORO AR
72401-7213
US

V. Phone/Fax

Practice location:
  • Phone: 870-919-3381
  • Fax:
Mailing address:
  • Phone: 870-972-4900
  • Fax: 870-972-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CARLA JONES
Title or Position: OFFICE MANAGER
Credential:
Phone: 870-972-4900