| Midsouth Health Systems | |
|
1201 Falls Blvd S Wynne AR 72396-3637 | |
| (870) 238-1135 | |
| (870) 972-4911 |
| Full Name | Midsouth Health Systems |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1201 Falls Blvd S, Wynne, Arkansas |
| Authorized Official Name and Position | Donnie Lyerly (CREDENTIALING) |
| Authorized Official Contact | 8709724939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midsouth Health Systems 2707 Browns Ln Jonesboro AR 72401-7213 Ph: (870) 972-4939 | Midsouth Health Systems 1201 Falls Blvd S Wynne AR 72396-3637 Ph: (870) 238-1135 |
| NPI Number | 1740573971 |
|---|---|
| Provider Enumeration Date | 05/20/2011 |
| Last Update Date | 04/25/2022 |
| Certification Date | 04/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740573971 | NPI | - | NPPES |
| 184169767 | 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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