Healthcare Provider Details
I. General information
NPI: 1932706918
Provider Name (Legal Business Name): VILLAGE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2020
Last Update Date: 10/03/2020
Certification Date: 10/03/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13 BELLEZA WAY
HOT SPRINGS VILLAGE AR
71909-7911
US
IV. Provider business mailing address
PO BOX 8463
HOT SPRINGS VILLAGE AR
71910-8463
US
V. Phone/Fax
- Phone: 501-503-1500
- Fax:
- Phone: 541-503-1500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GAIL
S
MAURER
Title or Position: MANAGER
Credential: PHD
Phone: 501-503-1500