1831216514 NPI number — TRINITY BEHAVIORAL HEALTH CARE SYSTEM INCORPORATED

Table of content: (NPI 1831216514)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831216514 NPI number — TRINITY BEHAVIORAL HEALTH CARE SYSTEM INCORPORATED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINITY BEHAVIORAL HEALTH CARE SYSTEM INCORPORATED
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:
Provider Other Organization Name Type Code:
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:
1831216514
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1033 OLD BURR ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARM SPRINGS
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72478
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-647-1400
Provider Business Mailing Address Fax Number:
870-647-2337

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1033 OLD BURR ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WARM SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72478
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-647-1400
Provider Business Practice Location Address Fax Number:
870-647-2337
Provider Enumeration Date:
03/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SUHL
Authorized Official First Name:
TED
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
870-647-1400

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 322D00000X , with the licence number: 10031 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 323P00000X , with the licence number: 10031 , 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)