Healthcare Provider Details
I. General information
NPI: 1366688103
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
3302 E MOORE AVE
SEARCY AR
72143-4886
US
IV. Provider business mailing address
25 GAP RD
BATESVILLE AR
72501-8679
US
V. Phone/Fax
- Phone: 501-268-4181
- Fax: 501-268-5301
- Phone: 870-793-8900
- Fax: 870-793-8959
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | AR |
VIII. Authorized Official
Name: MR.
BERNIS
MEDLOCK
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 870-793-8900