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General NPI Number Information
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NPI Number | 1134521685
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Entity Type | Organization
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Legal Business Name | WOODRIDGE OF WEST MEMPHIS, LLC
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Dates
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Enumeration Date | 09/16/2014
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 600 N 7TH ST
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City | WEST MEMPHIS
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State | AR
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Zip | 72301-3235
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Country | US
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Telephone | 870-394-7100
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Fax | 870-394-7111
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Provider Business Mailing Address
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Address Line | 2520 NORTHWINDS PARKWAY SUITE 550
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City | ALPHARETTA
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State | GA
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Zip | 30009
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Country | US
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Telephone | 470-554-7903
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Fax | 615-860-9228
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATIVE SERVICES
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Name | ROCHELLE GERBER
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Credential |
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Telephone | 470-554-7903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State | AR
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