Provider Demographics
NPI:1144404799
Name:THE P.A.T. (PEOPLE ADVOCATING TRANSITION) CENTER
Entity Type:Organization
Organization Name:THE P.A.T. (PEOPLE ADVOCATING TRANSITION) CENTER
Other - Org Name:THE P.A.T. CENTER: PEOPLE ADVOCATING TRANSITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-534-4900
Mailing Address - Street 1:620 SOUTH LAUREL STREET
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71601-4859
Mailing Address - Country:US
Mailing Address - Phone:870-534-4900
Mailing Address - Fax:870-534-4906
Practice Address - Street 1:620 SOUTH LAUREL STREET
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71601-4859
Practice Address - Country:US
Practice Address - Phone:870-534-4900
Practice Address - Fax:870-534-4906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR180635526Medicaid