Provider Demographics
NPI:1326167966
Name:ARKANSAS DEPARTMENT OF HUMAN SERVICES
Entity Type:Organization
Organization Name:ARKANSAS DEPARTMENT OF HUMAN SERVICES
Other - Org Name:CHILDRENS MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:501-682-1464
Mailing Address - Street 1:P O BOX 1437 SLOT N505
Mailing Address - Street 2:108 E 7TH ST
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203-1437
Mailing Address - Country:US
Mailing Address - Phone:501-682-8663
Mailing Address - Fax:501-683-5608
Practice Address - Street 1:700 MAIN ST
Practice Address - Street 2:SUITE S-380
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-4608
Practice Address - Country:US
Practice Address - Phone:501-682-1464
Practice Address - Fax:501-682-8247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management