1922323096 NPI number — NEW BEGINNINGS BEHAVIORAL HEALTH SERVICES

Table of content: (NPI 1922323096)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922323096 NPI number — NEW BEGINNINGS BEHAVIORAL HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW BEGINNINGS BEHAVIORAL HEALTH SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THERAPUETIC SERVICES OF ARKANSAS
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922323096
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/08/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 LILE COURT
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72205-6240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-663-1837
Provider Business Mailing Address Fax Number:
501-663-1839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LILE COURT
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72205-6240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-663-1837
Provider Business Practice Location Address Fax Number:
501-663-1839
Provider Enumeration Date:
04/01/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BAZZELLE
Authorized Official First Name:
CHIRIE
Authorized Official Middle Name:
LEDDELLE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
501-663-1837

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 182152526 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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