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General NPI Number Information
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NPI Number | 1467485680
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Entity Type | Organization
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Legal Business Name | TEXARKANA BEHAVIORAL ASSOCIATES LC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 801 ARKANSAS BLVD
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City | TEXARKANA
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State | AR
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Zip | 71854-2107
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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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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 FARLEY
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Credential |
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Telephone | 615-861-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | PENDING
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License Number State | AR
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