NPIMap

Organization Active NPI

Conway County Community Service, Inc

  • Community/Behavioral Health Agency
  • Berryville, AR
National Provider Identifier
1699360420
Registry record updated Mar 3, 2021
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
804 W Freeman Ave
Berryville, AR 72616-3106
Phone
(870) 280-3468
NPI assigned
Mar 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

804 W Freeman Ave
Berryville, AR 72616-3106

Mailing address

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

Other names 1

  • Community Service, Inc-Berryville Other name

National Provider Directory

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

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": "1614729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614729600000",
    "number": "1699360420",
    "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": "804 W FREEMAN AVE",
            "city": "BERRYVILLE",
            "state": "AR",
            "postal_code": "726163106",
            "telephone_number": "870-280-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY COUNTY COMMUNITY SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "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": [
        {
            "organization_name": "Community Service, Inc-Berryville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 3, 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.