Healthcare Provider Details

I. General information

NPI: 1902178619
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: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N CLIFTON ST
FORDYCE AR
71742
US

IV. Provider business mailing address

300 N CLIFTON ST
FORDYCE AR
71742-3055
US

V. Phone/Fax

Practice location:
  • Phone: 870-352-5122
  • Fax: 870-352-5127
Mailing address:
  • Phone: 870-352-5122
  • Fax: 870-352-5127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent 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