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General NPI Number Information
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NPI Number | 1972832905
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Entity Type | Organization
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Legal Business Name | HILLCREST CENTER FOR EMOTIONAL WELLBEING
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 12/22/2009
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Provider Practice Location Address
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Address Line | 2701 KAVANAUGH BLVD STE 209
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3872
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Country | US
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Telephone | 501-551-1545
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 KAVANAUGH BLVD STE 209
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3872
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Country | US
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Telephone | 501-551-1545
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DAVID STREETT
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Credential | MD
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Telephone | 501-551-1545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional 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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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