=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255175295
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CLOUD PSYCHIATRIC CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/24/2024
-----------------------------------------------------
Last Update Date | 12/11/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 335 SECTION LINE RD UNIT 20152
-----------------------------------------------------
City | HOT SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71903-7927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-214-9450
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 335 SECTION LINE RD UNIT 20152
-----------------------------------------------------
City | HOT SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 71903-7927
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-214-9450
-----------------------------------------------------
Fax | 501-232-4247
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ PSYCHIATRIC NURSE PRACTITIONER
-----------------------------------------------------
Name | SARAH MARGARET CLOUD
-----------------------------------------------------
Credential | APRN
-----------------------------------------------------
Telephone | 501-214-9450
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------