| Rock Behavioral Health, Llc | |
|
1217 Hendrix Ave Little Rock AR 72204-2630 | |
| (501) 553-5593 | |
| Not Available |
| Full Name | Rock Behavioral Health, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1217 Hendrix Ave, Little Rock, Arkansas |
| Authorized Official Name and Position | Ryan Leslie (OWNER) |
| Authorized Official Contact | 5012559131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rock Behavioral Health, Llc 6834 Cantrell Rd # 1181 Little Rock AR 72207-4135 Ph: () - | Rock Behavioral Health, Llc 1217 Hendrix Ave Little Rock AR 72204-2630 Ph: (501) 553-5593 |
| NPI Number | 1770358897 |
|---|---|
| Provider Enumeration Date | 11/20/2023 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Medicare PECOS PAC ID | 4789034141 |
|---|---|
| Medicare Enrollment ID | O20231227001483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770358897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Ryan Np Leslie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639701022 PECOS PAC ID: 0446680284 Enrollment ID: I20200420001441 |
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