NPIMap

Organization Active NPI

Conway County Community Service, Inc

  • Community/Behavioral Health Agency
  • Berryville, AR
National Provider Identifier
1023854668
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CONWAY COUNTY COMMUNITY SERVICE, INC
Practice address
605 Eureka Ave Ste C
Berryville, AR 72616-3035
Phone
(870) 929-6023
Fax
(870) 505-2003
NPI assigned
Jul 3, 2024
Last updated
Jul 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
CONWAY COUNTY COMMUNITY SERVICE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angela Lynn Wheat
Title
PA/Credentialing Clerk
Phone
(501) 354-4589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

605 Eureka Ave Ste C
Berryville, AR 72616-3035

Mailing address

PO Box 679
Morrilton, AR 72110-0679
Phone (501) 354-4589

National Provider Directory

National Provider Directory
Tax ID family
Conway County Comm Serv Inc21 organizations share this tax ID, including this one
Part of
Conway County Comm Serv Inc

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1023854668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 679",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721100679",
            "telephone_number": "501-354-4589",
            "fax_number": "501-354-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 EUREKA AVE STE C",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726163035",
            "telephone_number": "870-929-6023",
            "fax_number": "870-505-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY COUNTY COMMUNITY SERVICE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONWAY COUNTY COMMUNITY SERVICE, INC",
        "enumeration_date": "2024-07-03",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "WHEAT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PA/CREDENTIALING CLERK",
        "authorized_official_telephone_number": "501-354-4589"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berryville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.