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General NPI Number Information
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NPI Number | 1578086526
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Entity Type | Organization
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Legal Business Name | ARKANSAS MOUNTAIN CONSULTANTS AND COUNSELING
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Dates
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Enumeration Date | 07/21/2017
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Last Update Date | 07/21/2017
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Provider Practice Location Address
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Address Line | 1401 MALVERN AVE STE 210
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City | HOT SPRINGS
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State | AR
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Zip | 71901-6371
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Country | US
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Telephone | 501-213-8607
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Fax |
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Provider Business Mailing Address
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Address Line | 2106 CHELSEA DR.
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City | BRYANT
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State | AR
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Zip | 72022
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID HENDRIX
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Credential | LCSW
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Telephone | 501-590-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 811122292
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License Number State | AR
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