Reform, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

REFORM, INC.

Practice address

807 W 6TH Ave
Pine Bluff, AR 71601-4031

Phone

(870) 510-5031

Fax

(501) 421-3418

NPI assigned

Sep 3, 2020

Organization subpart

No

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

Authorized official

Name

Melrita Johnson

Title

Owner

Phone

(870) 510-5031

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1174137343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716132077",
            "telephone_number": "870-510-5031",
            "fax_number": "501-421-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 W 6TH AVE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716014031",
            "telephone_number": "870-510-5031",
            "fax_number": "501-421-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFORM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-03",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MELRITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-510-5031"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.