Healthcare Provider Details

I. General information

NPI: 1972083806
Provider Name (Legal Business Name): NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2018
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3204 E MOORE AVE
SEARCY AR
72143-4826
US

IV. Provider business mailing address

2707 BROWNS LN
JONESBORO AR
72401-7213
US

V. Phone/Fax

Practice location:
  • Phone: 870-919-6320
  • Fax:
Mailing address:
  • Phone: 870-972-4900
  • Fax: 870-972-4968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: CARLA JONES
Title or Position: OFFICE MANAGER
Credential:
Phone: 870-972-4900