Behavioral Health Services of West Memphis LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

BEHAVIORAL HEALTH SERVICES OF WEST MEMPHIS LLC

Practice address

410 S Avalon St
West Memphis, AR 72301-4183

Phone

(561) 635-2400

NPI assigned

Jul 11, 2023

Last updated

Feb 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kirill Vesselov

Title

Owner

Phone

(561) 635-2400

Specialties & licenses 3

Addresses

Tax ID family

Behavioral Health Services of West Memphis LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Behavioral Health Services of West Memphis LLC

  • Psychiatric Hospital
  • West Memphis, AR
  • NPI 1144169079
  NPD tax ID

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1821777566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 10TH AVE N",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334613000",
            "telephone_number": "561-635-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S AVALON ST",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "723014183",
            "telephone_number": "561-635-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH SERVICES OF WEST MEMPHIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "VESSELOV",
        "authorized_official_first_name": "KIRILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-635-2400"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hubert Bass
• Mario Bass
• Shakita Baxter
• Lenora Beason
• Behavioral Health Services of West Memphis LLC
• Behavioral Health WM Operating Subsidiary, LLC
• Latasha Bell
• Brookelyn Marie Bellah, OTR/L
• Hannah Benedetti
• Bennett L Rudorfer MD PA

• Substance Abuse Rehabilitation Facility in West Memphis, AR
• Providers in West Memphis, AR by specialty
• Substance Abuse Rehabilitation Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.