Healthcare Provider Details

I. General information

NPI: 1770738734
Provider Name (Legal Business Name): SOUTHEAST ARKANSAS BEHAVIORAL HEALTHCARE SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N OAK ST
SHERIDAN AR
72150-2133
US

IV. Provider business mailing address

2500 RIKE DR
PINE BLUFF AR
71603-3937
US

V. Phone/Fax

Practice location:
  • Phone: 870-942-5101
  • Fax: 870-942-7123
Mailing address:
  • Phone: 870-534-1834
  • Fax: 870-534-5798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CLARENCE W PERKINS
Title or Position: PRESIDENT, CEO
Credential:
Phone: 870-534-1834