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General NPI Number Information
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NPI Number | 1316071228
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Entity Type | Organization
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Legal Business Name | TEXARKANA BEHAVIORAL ASOCIATES LC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/27/2023
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Provider Practice Location Address
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Address Line | 10301 MAYO DR
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City | BARLING
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State | AR
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Zip | 72923-1660
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Country | US
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Telephone | 479-494-5700
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Fax | 479-484-8142
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Provider Business Mailing Address
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Address Line | 4253 N CROSSOVER RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4593
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Country | US
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Telephone | 479-521-5731
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Fax | 479-521-4926
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Authorized Official
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Title or Position | VICE PRESIDENT & SECRETARY
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Name | BRIAN P. FARLEY
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Credential |
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Telephone | 615-861-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | AR4151
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License Number State | AR
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