Healthcare Provider Details
I. General information
NPI: 1710259437
Provider Name (Legal Business Name): BHC PINNACLE POINTE HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2012
Last Update Date: 06/30/2023
Certification Date: 10/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
910 N EAST ST
BENTON AR
72015-3327
US
IV. Provider business mailing address
910 N EAST ST
BENTON AR
72015-3327
US
V. Phone/Fax
- Phone: 501-381-2001
- Fax: 501-381-2005
- Phone: 501-381-2991
- Fax: 501-381-2005
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHANE
FRAZIER
Title or Position: CEO
Credential:
Phone: 501-223-3322