| Reform, Inc. | |
|
807 W 6th Ave Pine Bluff AR 71601-4031 | |
| (870) 510-5031 | |
| (501) 421-3418 |
| Full Name | Reform, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 807 W 6th Ave, Pine Bluff, Arkansas |
| Authorized Official Name and Position | Melrita Johnson (OWNER) |
| Authorized Official Contact | 8705105031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reform, Inc. Po Box 2077 Pine Bluff AR 71613-2077 Ph: (870) 510-5031 | Reform, Inc. 807 W 6th Ave Pine Bluff AR 71601-4031 Ph: (870) 510-5031 |
| NPI Number | 1174137343 |
|---|---|
| Provider Enumeration Date | 09/03/2020 |
| Last Update Date | 05/20/2021 |
| Certification Date | 05/20/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174137343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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