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General NPI Number Information
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NPI Number | 1134688898
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Entity Type | Organization
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Legal Business Name | ARKANSAS DEMENTIA AND BEHAVIORAL HEALTH RESEARCH CENTER, LLC
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 11321 INTERSTATE 30 STE 308
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City | LITTLE ROCK
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State | AR
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Zip | 72209-7067
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Country | US
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Telephone | 501-492-9175
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Fax |
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Provider Business Mailing Address
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Address Line | 11321 INTERSTATE 30 STE 308
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City | LITTLE ROCK
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State | AR
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Zip | 72209-7067
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NAVEEN KUMAR
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Credential | MD
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Telephone | 501-681-1972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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