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General NPI Number Information
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NPI Number | 1689989147
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Entity Type | Organization
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Legal Business Name | BAILEY BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 03/25/2015
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Provider Practice Location Address
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Address Line | 702 N MAIN ST SUITE F
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City | HARRISON
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State | AR
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Zip | 72601-2900
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Country | US
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Telephone | 870-204-6980
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Fax | 870-204-6981
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Provider Business Mailing Address
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Address Line | 702 N MAIN ST SUITE F
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City | HARRISON
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State | AR
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Zip | 72601-2900
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Country | US
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Telephone | 870-204-6980
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Fax | 870-204-6981
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID W BAILEY
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Credential | LCSW
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Telephone | 870-204-6980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2407-C
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License Number State | AR
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