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701 Arkansas Boulevard Texarkana AR 71854 | |
| (870) 772-5028 | |
| (870) 774-1146 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 701 Arkansas Boulevard, Texarkana, Arkansas |
| Authorized Official Name and Position | Brian P. Farley (VICE PRESIDENT & SECRETARY) |
| Authorized Official Contact | 6158616000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6100 Tower Cir Ste 1000 Franklin TN 37067-1509 Ph: (615) 861-6000 | 701 Arkansas Boulevard Texarkana AR 71854 Ph: (870) 772-5028 |
| NPI Number | 1841216538 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 08/28/2023 |
| Certification Date | 08/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841216538 | NPI | - | NPPES |
| PENDING | Other | AR | BLUE CROSS GROUP NUMBER |
| PENDING | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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