Healthcare Provider Details

I. General information

NPI: 1235375080
Provider Name (Legal Business Name): HEALTH RESOURCES OF ARKANSAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 HIGHWAY 5
ROSE BUD AR
72137-9721
US

IV. Provider business mailing address

25 GAP RD
BATESVILLE AR
72501-8679
US

V. Phone/Fax

Practice location:
  • Phone: 501-556-4210
  • Fax: 501-556-4171
Mailing address:
  • Phone: 870-793-8900
  • Fax: 870-793-8959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateAR

VIII. Authorized Official

Name: MR. BERNIS MEDLOCK
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 870-793-8900