Healthcare Provider Details

I. General information

NPI: 1942316310
Provider Name (Legal Business Name): TEXARKANA BEHAVIORAL ASSOCIATES, L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SAW GRASSE POINT
HARRISON AR
72601
US

IV. Provider business mailing address

6100 TOWER CIR STE 10000
FRANKLIN TN
37067-1451
US

V. Phone/Fax

Practice location:
  • Phone: 479-521-5731
  • Fax: 479-521-7683
Mailing address:
  • Phone: 615-861-6000
  • Fax: 615-261-9685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberAR3854
License Number StateAR

VIII. Authorized Official

Name: BRIAN P. FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-861-6000