Healthcare Provider Details

I. General information

NPI: 1356593669
Provider Name (Legal Business Name): THE UNITED METHODIST CHILDREN'S HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 10/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ALDERSGATE RD SUITE 200
LITTLE ROCK AR
72205-6614
US

IV. Provider business mailing address

471 PHILLIPS ROAD 251
LEXA AR
72355-8325
US

V. Phone/Fax

Practice location:
  • Phone: 501-661-0720
  • Fax: 501-687-0839
Mailing address:
  • Phone: 870-572-2409
  • Fax: 870-572-2871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: BECKY JONES
Title or Position: CFO
Credential:
Phone: 501-661-0720