| NPI | 1891230835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY HARRISON JENKINS Office Manager 479-367-2552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 101YP2500X Counselor Professional | |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| 2084S0012X Psychiatry & Neurology Sleep Medicine | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2025-06-11 |