| Exodus.life | |
|
3700 W 65th St Little Rock AR 72209-8552 | |
| (501) 680-7644 | |
| Not Available |
| Full Name | Exodus.life |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3700 W 65th St, Little Rock, Arkansas |
| Authorized Official Name and Position | Melrita Maechel Johnson (CLINICAL DIRECTOR) |
| Authorized Official Contact | 5016807644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Exodus.life 3700 W 65th St Little Rock AR 72209-8552 Ph: (501) 680-7644 | Exodus.life 3700 W 65th St Little Rock AR 72209-8552 Ph: (501) 680-7644 |
| NPI Number | 1437889185 |
|---|---|
| Provider Enumeration Date | 06/15/2022 |
| Last Update Date | 06/15/2022 |
| Certification Date | 06/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437889185 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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