| The Telos Clinic L.l.c. | |
|
11917 Saint Charles Blvd Little Rock AR 72211-2319 | |
| (501) 944-0659 | |
| Not Available |
| Full Name | The Telos Clinic L.l.c. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11917 Saint Charles Blvd, Little Rock, Arkansas |
| Authorized Official Name and Position | Zachery Otwell (OWNER) |
| Authorized Official Contact | 5019440659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Telos Clinic L.l.c. 11917 Saint Charles Blvd Little Rock AR 72211-2319 Ph: (501) 944-0659 | The Telos Clinic L.l.c. 11917 Saint Charles Blvd Little Rock AR 72211-2319 Ph: (501) 944-0659 |
| NPI Number | 1205601820 |
|---|---|
| Provider Enumeration Date | 11/24/2023 |
| Last Update Date | 11/24/2023 |
| Certification Date | 11/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205601820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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