Healthcare Provider Details

I. General information

NPI: 1841216538
Provider Name (Legal Business Name): TEXARKANA BEHAVIORAL ASSOCIATES, L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/28/2023
Certification Date: 08/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 ARKANSAS BOULEVARD
TEXARKANA AR
71854
US

IV. Provider business mailing address

6100 TOWER CIR STE 1000
FRANKLIN TN
37067-1509
US

V. Phone/Fax

Practice location:
  • Phone: 870-772-5028
  • Fax: 870-774-1146
Mailing address:
  • Phone: 615-861-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BRIAN P. FARLEY
Title or Position: VICE PRESIDENT & SECRETARY
Credential:
Phone: 615-861-6000