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General NPI Number Information
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NPI Number | 1871391987
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Entity Type | Organization
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Legal Business Name | PATH PSYCHIATRIC-MENTAL HEALTH, LLC.
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 109 S 3RD ST STE B
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-3805
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Country | US
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Telephone | 501-474-6152
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Fax | 501-382-0235
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Provider Business Mailing Address
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Address Line | 109 S 3RD ST STE B
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City | HEBER SPRINGS
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State | AR
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Zip | 72543-3805
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Country | US
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Telephone | 501-474-6152
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Fax | 501-382-0235
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Authorized Official
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Title or Position | INCORPORATOR/ORGANIZER
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Name | LESLIE ROSE WILLIAMS
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Credential | APRN, PMHNP-BC
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Telephone | 501-206-4466
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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 |
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License Number State |
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