| NPI | 1437750411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BUNCH Credentialing Supervisor 479-725-5115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 1041C0700X Social Worker, Clinical | |
| 171M00000X Case Manager/Care Coordinator | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| 163W00000X Registered Nurse | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| 101YP2500X Counselor, Professional | |
| 164W00000X Licensed Practical Nurse | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 103TC1900X Psychologist, Counseling | |
| 101YM0800X Counselor, Mental Health | |
| 251S00000X Community/Behavioral Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2025-12-10 |