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General NPI Number Information
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NPI Number | 1487316576
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Entity Type | Organization
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Legal Business Name | ADVOCATE MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 1124 S ROGERS ST STE 3
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City | CLARKSVILLE
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State | AR
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Zip | 72830-7046
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Country | US
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Telephone | 479-309-9029
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Fax | 479-398-8346
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Provider Business Mailing Address
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Address Line | PO BOX 233
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City | KNOXVILLE
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State | AR
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Zip | 72845-0233
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Country | US
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Telephone | 479-518-8549
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | MARCIA LYNN MCGLONE
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Credential | APRN
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Telephone | 479-518-8549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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