Healthcare Provider Details

I. General information

NPI: 1073666475
Provider Name (Legal Business Name): MORRILTON HUMAN RELATIONS COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 N DIVISION ST
MORRILTON AR
72110-2016
US

IV. Provider business mailing address

706 N DIVISION ST
MORRILTON AR
72110-2016
US

V. Phone/Fax

Practice location:
  • Phone: 501-354-8044
  • Fax: 501-354-0502
Mailing address:
  • Phone: 501-354-8044
  • Fax: 501-354-0502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateAR

VIII. Authorized Official

Name: MS. DIANE D. WILSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 15013548044