Susan Beavers, RECOVERY ASSISTANT

Individual provider Active NPI Case Manager/Care Coordinator · Clinton, AR

NPI 1073752200 · NPPES record last updated Jun 20, 2011

Key facts

NPI
1073752200
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
242 Shake Rag Rd
Clinton, AR 72031-6629
Phone
(501) 745-6644
NPI assigned
Feb 11, 2009
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X AR Yes

Addresses

Primary practice location

242 Shake Rag Rd
Clinton, AR 72031-6629

Mailing address

PO Box 1589
Benton, AR 72018-1589
Phone (501) 315-3344

Other providers in Clinton, AR

All providers in Clinton, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.