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General NPI Number Information
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NPI Number | 1104033976
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Entity Type | Organization
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Legal Business Name | AMERIS OF ARKANSAS, LLC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 611 W LEE AVE
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City | OSCEOLA
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State | AR
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Zip | 72370-3001
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Country | US
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Telephone | 870-563-7000
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Fax | 870-838-7493
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Provider Business Mailing Address
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Address Line | 1114 17TH AVE S
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City | NASHVILLE
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State | TN
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Zip | 37212-2215
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Country | US
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Telephone | 615-327-4440
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Fax | 615-327-0898
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LUTHER RAMSAY
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Credential |
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Telephone | 615-327-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 20102
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License Number State | AR
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