| Center For Eating Disorders And Behavioral Wellness Plc | |
|
218 Union St Ste C Jonesboro AR 72401-2831 | |
| (870) 530-6104 | |
| Not Available |
| Full Name | Center For Eating Disorders And Behavioral Wellness Plc |
|---|---|
| Speciality | Social Worker |
| Location | 218 Union St Ste C, Jonesboro, Arkansas |
| Authorized Official Name and Position | Keena Reddin (OWNER) |
| Authorized Official Contact | 8707614796 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Eating Disorders And Behavioral Wellness Plc 218 Union St Ste C Jonesboro AR 72401-2831 Ph: (870) 530-6104 | Center For Eating Disorders And Behavioral Wellness Plc 218 Union St Ste C Jonesboro AR 72401-2831 Ph: (870) 530-6104 |
| NPI Number | 1336633387 |
|---|---|
| Provider Enumeration Date | 06/21/2018 |
| Last Update Date | 03/28/2021 |
| Certification Date | 03/28/2021 |
| Medicare PECOS PAC ID | 2769732106 |
|---|---|
| Medicare Enrollment ID | O20180906001250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336633387 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6572-C (Arkansas) | Primary |
| Provider Name | Keena M Reddin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497110043 PECOS PAC ID: 0648561134 Enrollment ID: I20160613002135 |
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