| West Memphis After School Program | |
|
703 Calvin Avery Dr West Memphis AR 72301-6501 | |
| (870) 732-1817 | |
| (870) 702-7111 |
| Full Name | West Memphis After School Program |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 703 Calvin Avery Dr, West Memphis, Arkansas |
| Authorized Official Name and Position | Shella Pounds (COMPLIANCE OFFICER) |
| Authorized Official Contact | 8707321878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Memphis After School Program 304 N 6th St West Memphis AR 72301-3221 Ph: (870) 702-7657 | West Memphis After School Program 703 Calvin Avery Dr West Memphis AR 72301-6501 Ph: (870) 732-1817 |
| NPI Number | 1235375262 |
|---|---|
| Provider Enumeration Date | 12/22/2008 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235375262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Arkansas) | Primary |
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