Provider Demographics
NPI:1053448233
Name:ASCENT CHILDRENS HEATH SERVICES
Entity Type:Organization
Organization Name:ASCENT CHILDRENS HEATH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH AND SAFETY
Authorized Official - Prefix:MRS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:501-326-6160
Mailing Address - Street 1:3002 PRIMROSE DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-2698
Mailing Address - Country:US
Mailing Address - Phone:501-315-6543
Mailing Address - Fax:
Practice Address - Street 1:3214 WINCHESTER DR.
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015
Practice Address - Country:US
Practice Address - Phone:501-326-6160
Practice Address - Fax:501-326-6161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR50204261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center