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477 N Hazen Ave Hazen AR 72064-8072 | |
(501) 661-0720 | |
Not Available |
Full Name | |
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Speciality | Counselor |
Location | 477 N Hazen Ave, Hazen, Arkansas |
Authorized Official Name and Position | Cyndi Coleman (PROGRAM DIRECTOR) |
Authorized Official Contact | 5018033388 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1600 Aldersgate Rd Suite 200 Little Rock AR 72205-6614 Ph: (501) 661-0720 | 477 N Hazen Ave Hazen AR 72064-8072 Ph: (501) 661-0720 |
NPI Number | 1497993398 |
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Provider Enumeration Date | 01/30/2009 |
Last Update Date | 01/30/2009 |
Identifier | Type | State | Issuer |
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1497993398 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101Y00000X | Counselor | (* (Not Available)) | Primary |