Northeast Arkansas Community Mental Health Center
Organization Active NPI Community/Behavioral Health Agency · West Memphis, AR
NPI 1598058489 · NPPES record last updated Dec 12, 2012
Key facts
- NPI
- 1598058489
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER
- Practice address
- 905 N 7TH St
West Memphis, AR 72301-2001 - Phone
- (870) 735-4511
- Fax
- (870) 735-5260
- NPI assigned
- May 25, 2011
- Organization subpart
- Yes
- Parent organization (as reported)
- NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER
Authorized official
- Name
- Donnie Lyerly
- Title
- Credentialing
- Phone
- (870) 972-4939
Corporate family (same tax ID) 42
National Provider Directory
- Tax ID family
- Northeast Arkansas Community Mental Health Center
- Part of
- Northeast Arkansas Community Mental Health Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
905 N 7TH St
West Memphis, AR 72301-2001
Mailing address
2707 Browns LN
Jonesboro, AR 72401-7213
Phone (870) 972-4939
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18417774 | Medicaid | AR |
Other names
- MidSouth Health Systems
Other providers in West Memphis, AR
- Decrecia Nevels
- Bryce Newsome
- Emily Nichols
- Kelby Renee Nicholson
- Grace Norcross Niclosi
- Northeast Arkansas Community Mental Health Center Inc
- Northeast Arkansas Community Mental Health Center Inc
- Victoria Ruth Norton
- Laura Null
- Courtney Yvette Nunnally
All providers in West Memphis, AR · Community/Behavioral Health Agency in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.