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1425 W Main St Walnut Ridge AR 72476-1431 | |
(870) 886-5303 | |
(870) 886-7002 |
Full Name | |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 1425 W Main St, Walnut Ridge, Arkansas |
Authorized Official Name and Position | Mark A. Thurman (CEO) |
Authorized Official Contact | 8709336886 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1815 Pleasant Grove Rd Jonesboro AR 72405-7870 Ph: (870) 933-6886 | 1425 W Main St Walnut Ridge AR 72476-1431 Ph: (870) 886-5303 |
NPI Number | 1447421169 |
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Provider Enumeration Date | 03/20/2008 |
Last Update Date | 03/09/2021 |
Certification Date | 03/09/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447421169 | NPI | - | NPPES |
145559726 | Medicaid | AR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |