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NPI Code Detail

MEDICARE: AMERIS OF ARKANSAS, LLC

MEDICARE: AMERIS OF ARKANSAS, 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
1273R00000XPsychiatric Hospital UnitAR4258AR

General Provider Information

NPI Number : 1548325251
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERIS OF ARKANSAS, LLC
Provider Business Mailing Address
First Line : PO BOX 167
Second Line :
City : BLYTHEVILLE
State : AR
Zip : 72316-0167
Country : US
Telephone Number : 870-838-7213
Fax Number : 870-838-7100
Provider Business Practice Location Address
First Line : 1520 N DIVISION ST
Second Line :
City : BLYTHEVILLE
State : AR
Zip : 72315-1448
Country : US
Telephone Number : 870-838-7213
Fax Number : 870-838-7100
Authorized Official
Title or Position : CFO
Name : DAVID LYNN
Credential :
Telephone Number : 870-838-7462
Provider Enumeration Date : 12/22/2006
Last Update Date : 08/22/2020

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Directions to “AMERIS OF ARKANSAS, LLC ” Practice Location

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