MEDICARE: UNITY HEALTH - JACKSONVILLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1245954460
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITY HEALTH - JACKSONVILLE

Provider Business Mailing Address
First Line	:	1400 BRADEN ST
Second Line	:
City	:	JACKSONVILLE
State	:	AR
Zip	:	72076-3721
Country	:	US
Telephone Number	:	501-453-5002
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 BRADEN ST
Second Line	:
City	:	JACKSONVILLE
State	:	AR
Zip	:	72076-3721
Country	:	US
Telephone Number	:	501-453-5002
Fax Number	:

Authorized Official
Title or Position	:	INTERIM ADMINISTRATOR
Name	:	RAMONA STATON
Credential	:
Telephone Number	:	501-453-5003

Provider Enumeration Date	:	09/30/2022
Last Update Date	:	04/07/2026

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