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NPI Code Detail

MEDICARE: CONWAY BEHAVIORAL HEALTH, LLC

MEDICARE: CONWAY BEHAVIORAL HEALTH, LLC
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
12084P0800XPsychiatry Physician
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3283Q00000XPsychiatric Hospital

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528508108
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONWAY BEHAVIORAL HEALTH, LLC
Provider Business Mailing Address
First Line : 6100 TOWER CIR STE 1000
Second Line :
City : FRANKLIN
State : TN
Zip : 37067-1509
Country : US
Telephone Number : 615-861-6000
Fax Number :
Provider Business Practice Location Address
First Line : 2255 STURGIS ROAD
Second Line :
City : CONWAY
State : AR
Zip : 72034-8334
Country : US
Telephone Number : 615-861-6000
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT & SECRETARY
Name : MR. BRIAN P. FARLEY
Credential :
Telephone Number : 615-861-6000
Provider Enumeration Date : 03/02/2017
Last Update Date : 08/24/2023

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Directions to “CONWAY BEHAVIORAL HEALTH, LLC ” Practice Location

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