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General NPI Number Information
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NPI Number | 1700150471
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Entity Type | Organization
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Legal Business Name | COMMUNITY EMPOWERMENT COUNCIL, INC.
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Dates
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Enumeration Date | 02/28/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 5830 HWY 65 SOUTH
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City | PINE BLUFF
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State | AR
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Zip | 71601
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Country | US
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Telephone | 870-536-1600
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Fax | 870-536-1601
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Provider Business Mailing Address
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Address Line | 5830 HWY 65 SOUTH
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City | PINE BLUFF
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State | AR
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Zip | 71601
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Country | US
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Telephone | 870-536-1600
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Fax | 870-536-1601
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | ANTONIO JERMAINE ANDERSON
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Credential |
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Telephone | 870-536-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | AR
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