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General NPI Number Information
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NPI Number | 1205172335
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Entity Type | Organization
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Legal Business Name | CARES BEHAVIORAL SERVICES
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 1116 S STATE ST
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City | PINE BLUFF
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State | AR
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Zip | 71601-5851
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Country | US
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Telephone | 870-293-4478
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Fax | 870-293-4834
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Provider Business Mailing Address
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Address Line | 1116 STATE AVE
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City | PINE BLUFF
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State | AR
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Zip | 71601
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Country | US
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Telephone | 870-293-4478
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Fax | 870-293-4823
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. PATSY PACE
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Credential | LPC
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Telephone | 870-293-4478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0256L
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2016009
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License Number State | AR
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