NPIMap

Organization Active NPI

South Arkansas Regional Health Center, Community Support Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • El Dorado, AR
National Provider Identifier
1992919047
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTH ARKANSAS REGIONAL HEALTH CENTER, COMMUNITY SUPPORT PROGRAM
Practice address
715 N College Ave
El Dorado, AR 71730-4403
Phone
(870) 864-7921
Fax
(870) 864-2490
NPI assigned
May 9, 2007
Organization subpart
Yes
Parent organization
SOUTH ARKANSAS REGIONAL HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Dr. William C Peel, PHD
Title
Executive Director
Phone
(870) 862-7921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

715 N College Ave
El Dorado, AR 71730-4403

Mailing address

715 N College Ave
El Dorado, AR 71730-4403
Phone (870) 864-7921

Other identifiers 1

IdentifierTypeStateIssuer
138435726MedicaidAR

National Provider Directory

National Provider Directory
Tax ID family
South Arkansas Regional Health Center Psy GRP17 organizations share this tax ID, including this one
Part of
South Arkansas Regional Health Center Psy GRP

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1992919047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304403",
            "telephone_number": "870-864-7921",
            "fax_number": "870-864-2490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N COLLEGE AVE",
            "city": "EL DORADO",
            "state": "AR",
            "postal_code": "717304403",
            "telephone_number": "870-864-7921",
            "fax_number": "870-864-2490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ARKANSAS REGIONAL HEALTH CENTER, COMMUNITY SUPPORT PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH ARKANSAS REGIONAL HEALTH CENTER",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "PEEL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "870-862-7921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "138435726",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.