Provider Demographics
NPI:1043505811
Name:HEALTH RESOURCES OF AR
Entity Type:Organization
Organization Name:HEALTH RESOURCES OF AR
Other - Org Name:GRAY'S CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-793-8900
Mailing Address - Street 1:477 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-5629
Mailing Address - Country:US
Mailing Address - Phone:870-793-8900
Mailing Address - Fax:
Practice Address - Street 1:477 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-5629
Practice Address - Country:US
Practice Address - Phone:870-793-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health