| Mid South Health Systems, Inc. | |
|
209 S Lockard St Blytheville AR 72315-2541 | |
| (870) 763-2139 | |
| (870) 972-4911 |
| Full Name | Mid South Health Systems, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 209 S Lockard St, Blytheville, Arkansas |
| Authorized Official Name and Position | Carla Jones (OFFICE MANAGER) |
| Authorized Official Contact | 8709724900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid South Health Systems, Inc. 2707 Browns Ln Jonesboro AR 72401-7213 Ph: (870) 972-4000 | Mid South Health Systems, Inc. 209 S Lockard St Blytheville AR 72315-2541 Ph: (870) 763-2139 |
| NPI Number | 1043461510 |
|---|---|
| Provider Enumeration Date | 10/02/2008 |
| Last Update Date | 04/22/2022 |
| Certification Date | 04/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043461510 | NPI | - | NPPES |
| 172110526 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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