| Community Service Inc. - Russellville | |
|
1505 S Oswego Ave Russellville AR 72802-2673 | |
| (479) 967-3370 | |
| (479) 967-2775 |
| Full Name | Community Service Inc. - Russellville |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1505 S Oswego Ave, Russellville, Arkansas |
| Authorized Official Name and Position | Angela Lynn Wheat (PA/CREDENTIALING CLERK) |
| Authorized Official Contact | 5013544589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Service Inc. - Russellville 1505 S Oswego Ave Russellville AR 72802-2673 Ph: (479) 967-3370 | Community Service Inc. - Russellville 1505 S Oswego Ave Russellville AR 72802-2673 Ph: (479) 967-3370 |
| NPI Number | 1134354400 |
|---|---|
| Provider Enumeration Date | 05/15/2009 |
| Last Update Date | 03/03/2021 |
| Certification Date | 03/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134354400 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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