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1520 N Division St Blytheville AR 72315-1448 | |
| (870) 838-7460 | |
| (870) 838-7493 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1520 N Division St, Blytheville, Arkansas |
| Authorized Official Name and Position | Chris L Raymer (COO/CNO) |
| Authorized Official Contact | 8708387460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1520 N Division St Blytheville AR 72315-1448 Ph: (870) 838-7460 | 1520 N Division St Blytheville AR 72315-1448 Ph: (870) 838-7460 |
| NPI Number | 1194009019 |
|---|---|
| Provider Enumeration Date | 10/11/2011 |
| Last Update Date | 10/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194009019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | AR4562 (Arkansas) | Primary |
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