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3822 N Parkview Dr Fayetteville AR 72703-6286 | |
| (479) 332-5356 | |
| (479) 367-2868 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 3822 N Parkview Dr, Fayetteville, Arkansas |
| Authorized Official Name and Position | Amber Barnes (UTILIZATION REVIEW MANAGER) |
| Authorized Official Contact | 5013812001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
910 N East St Benton AR 72015-3327 Ph: (501) 381-2001 | 3822 N Parkview Dr Fayetteville AR 72703-6286 Ph: (479) 332-5356 |
| NPI Number | 1528821808 |
|---|---|
| Provider Enumeration Date | 01/31/2024 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528821808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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