Provider Demographics
NPI:1003835257
Name:HAAS PSYCHIATRIC SERVICES, P.A.
Entity Type:Organization
Organization Name:HAAS PSYCHIATRIC SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HAAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-687-0488
Mailing Address - Street 1:2001 CLUB MANOR DR STE J
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7417
Mailing Address - Country:US
Mailing Address - Phone:501-687-0488
Mailing Address - Fax:501-687-0489
Practice Address - Street 1:2001 CLUB MANOR DR STE J
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-7417
Practice Address - Country:US
Practice Address - Phone:501-687-0488
Practice Address - Fax:501-687-0489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-0446261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
5C588OtherBCBS
=========OtherTIN
5C588OtherBCBS