Healthcare Provider Details

I. General information

NPI: 1063482735
Provider Name (Legal Business Name): UHS OF BENTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RIVENDELL DR
BENTON AR
72015-9188
US

IV. Provider business mailing address

100 RIVENDELL DR
BENTON AR
72015-9188
US

V. Phone/Fax

Practice location:
  • Phone: 501-316-1255
  • Fax:
Mailing address:
  • Phone: 501-316-1255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberAR4219
License Number StateAR

VIII. Authorized Official

Name: STEVE FILTON
Title or Position: SR VP CFO
Credential:
Phone: 610-768-3300