Healthcare Provider Details

I. General information

NPI: 1831216514
Provider Name (Legal Business Name): TRINITY BEHAVIORAL HEALTH CARE SYSTEM INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 OLD BURR ROAD
WARM SPRINGS AR
72478
US

IV. Provider business mailing address

1033 OLD BURR ROAD
WARM SPRINGS AR
72478
US

V. Phone/Fax

Practice location:
  • Phone: 870-647-1400
  • Fax: 870-647-2337
Mailing address:
  • Phone: 870-647-1400
  • Fax: 870-647-2337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number10031
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number10031
License Number StateAR

VIII. Authorized Official

Name: MR. TED SUHL
Title or Position: CEO
Credential:
Phone: 870-647-1400