| Child & Youth Development | |
|
800 S Church St Ste. 201 Jonesboro AR 72401-4176 | |
| (870) 935-9911 | |
| (870) 935-3450 |
| Full Name | Child & Youth Development |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 800 S Church St, Jonesboro, Arkansas |
| Authorized Official Name and Position | Holly A Allgood (INS BILLING REP) |
| Authorized Official Contact | 8708190232 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child & Youth Development 3012 Turman Dr Jonesboro AR 72404-8998 Ph: (870) 819-0200 | Child & Youth Development 800 S Church St Ste. 201 Jonesboro AR 72401-4176 Ph: (870) 935-9911 |
| NPI Number | 1205980497 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 02/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205980497 | NPI | - | NPPES |
| 160785526 | Medicaid | AR | |
| 160746742 | Medicaid | AR | |
| 57885 | Other | AR | ARKANSAS BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Arkansas) | Primary |
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