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Jefferson Comprehensive Counseling Associates

Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Pine Bluff, AR

NPI 1013461987 · NPPES record last updated Aug 9, 2016

Key facts

NPI
1013461987
Entity type
Organization (NPI type 2)
Primary specialty
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Legal business name
JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES
Practice address
2304 W 29TH Ave
Pine Bluff, AR 71603-5005
Phone
(870) 247-5222
Fax
(870) 671-4847
NPI assigned
Aug 9, 2016
Organization subpart
No

Authorized official

Name
Mr. Scott Aaron Mabry, CADC, CCS
Title
Clinical Director
Phone
(870) 247-5222

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Jefferson Comprehensive Counseling Associates (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Yes

Addresses

Primary practice location

2304 W 29TH Ave
Pine Bluff, AR 71603-5005

Mailing address

PO Box 21203
White Hall, AR 71612-1203
Phone (870) 247-5222

Other providers in Pine Bluff, AR

All providers in Pine Bluff, AR · Substance Use Disorder Rehabilitation Clinic/Center in Arkansas

Sources for this page

Verify at the official NPI Registry.