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General NPI Number Information
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NPI Number | 1447099056
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Entity Type | Organization
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Legal Business Name | SOUTH ARKANSAS REGIONAL HEALTH CENTER
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 05/28/2024
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Provider Practice Location Address
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Address Line | 2301 CHAMPAGNOLLE RD
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City | EL DORADO
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State | AR
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Zip | 71730-4816
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Country | US
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Telephone | 870-865-7908
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 CHAMPAGNOLLE RD
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City | EL DORADO
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State | AR
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Zip | 71730-4816
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Country | US
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Telephone | 870-865-7908
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Fax |
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Authorized Official
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Title or Position | BILLING SPECIALIST /CREDENTIALING C
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Name | HEATHER HOOVER
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Credential |
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Telephone | 870-864-2496
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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