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General NPI Number Information
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NPI Number | 1205001088
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Entity Type | Organization
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Legal Business Name | HOLDEN PSYCHIATRIC INSTITUTE, PA
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 2707 SE G ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-3740
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Country | US
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Telephone | 147-936-7255
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Fax | 479-367-2584
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Provider Business Mailing Address
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Address Line | 2707 SE G ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-3740
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Country | US
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Telephone | 479-367-2552
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Fax | 479-367-2584
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RANDY H JENKINS
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Credential |
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Telephone | 479-367-2552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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