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General NPI Number Information
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NPI Number | 1558681254
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Entity Type | Organization
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Legal Business Name | NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 02/21/2020
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Provider Practice Location Address
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Address Line | 4451 N WASHINGTON ST
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City | FORREST CITY
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State | AR
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Zip | 72335-7711
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Country | US
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Telephone | 870-630-3880
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Fax | 870-630-3892
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Provider Business Mailing Address
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Address Line | 2707 BROWNS LN
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City | JONESBORO
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State | AR
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Zip | 72401-7213
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Country | US
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Telephone | 870-972-4900
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Fax | 870-972-4968
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CARLA JONES
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Credential |
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Telephone | 870-972-4900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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