1356593669 NPI number — THE UNITED METHODIST CHILDREN'S HOME

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356593669 NPI number — THE UNITED METHODIST CHILDREN'S HOME

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE UNITED METHODIST CHILDREN'S HOME
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:
HELENA OUTPATIENT
Provider Other Organization Name Type Code:
3
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:
1356593669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
471 PHILLIPS ROAD 251
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEXA
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72355-8325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-572-2409
Provider Business Mailing Address Fax Number:
870-572-2871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 ALDERSGATE RD
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:
72205-6614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-661-0720
Provider Business Practice Location Address Fax Number:
501-687-0839
Provider Enumeration Date:
10/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
BECKY
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
501-661-0720

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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