Provider Demographics
NPI:1407089873
Name:HILL, FARIBI MACHE (MHPP)
Entity Type:Individual
Prefix:MRS
First Name:FARIBI
Middle Name:MACHE
Last Name:HILL
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21815 I 30
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-8031
Mailing Address - Country:US
Mailing Address - Phone:501-594-5200
Mailing Address - Fax:501-594-5244
Practice Address - Street 1:21815 I 30
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-8031
Practice Address - Country:US
Practice Address - Phone:501-594-5200
Practice Address - Fax:501-594-5244
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR905273501322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children