Healthcare Provider Details

I. General information

NPI: 1689877862
Provider Name (Legal Business Name): LIVING HOPE SOUTHEAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 W GAINES ST
MONTICELLO AR
71655-4637
US

IV. Provider business mailing address

555 W GAINES ST
MONTICELLO AR
71655-4637
US

V. Phone/Fax

Practice location:
  • Phone: 870-224-7100
  • Fax: 870-224-0373
Mailing address:
  • Phone: 870-224-7100
  • Fax: 870-224-0373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: LYNNE LINDSAY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 870-224-7100