Provider Demographics
NPI:1063661882
Name:DAVIS, HELEN (CHILD CASE MANAGERS)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CHILD CASE MANAGERS
Other - Prefix:MRS
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHILD CASE MANAGERS
Mailing Address - Street 1:790 ROBERTS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71655
Mailing Address - Country:US
Mailing Address - Phone:870-367-9732
Mailing Address - Fax:870-460-6133
Practice Address - Street 1:1308 W 5TH STREET
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635
Practice Address - Country:US
Practice Address - Phone:870-364-6471
Practice Address - Fax:870-364-9753
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker