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3205 Jenny Lind Rd Building D Fort Smith AR 72901-7101 | |
| (479) 785-2501 | |
| (479) 709-6059 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3205 Jenny Lind Rd, Fort Smith, Arkansas |
| Authorized Official Name and Position | Stevie Locke (SPECIAL ED SUPERVISOR) |
| Authorized Official Contact | 4797852501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1948 Fort Smith AR 72902-1948 Ph: (479) 785-2501 | 3205 Jenny Lind Rd Building D Fort Smith AR 72901-7101 Ph: (479) 785-2501 |
| NPI Number | 1952525685 |
|---|---|
| Provider Enumeration Date | 04/12/2007 |
| Last Update Date | 06/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952525685 | NPI | - | NPPES |
| 158216791 | Medicaid | AR |
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