| Identity Behavior Health Services, Llc | |
|
2401 Sheraton Park Dr Pine Bluff AR 71603-6869 | |
| (870) 267-2200 | |
| Not Available |
| Full Name | Identity Behavior Health Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2401 Sheraton Park Dr, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Kevin Barnett (OWNER) |
| Authorized Official Contact | 8702672200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Identity Behavior Health Services, Llc 2401 Sheraton Park Dr Pine Bluff AR 71603-6869 Ph: (870) 267-2200 | Identity Behavior Health Services, Llc 2401 Sheraton Park Dr Pine Bluff AR 71603-6869 Ph: (870) 267-2200 |
| NPI Number | 1609464775 |
|---|---|
| Provider Enumeration Date | 01/05/2021 |
| Last Update Date | 01/05/2021 |
| Certification Date | 01/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609464775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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