Provider Demographics
NPI:1407141583
Name:SOUTH ARKANSAS SUBSTANCE ABUSE
Entity Type:Organization
Organization Name:SOUTH ARKANSAS SUBSTANCE ABUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH SERVICES DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:FRANS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,LCSW
Authorized Official - Phone:870-881-9301
Mailing Address - Street 1:100 HARGETT DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-6521
Mailing Address - Country:US
Mailing Address - Phone:870-881-9301
Mailing Address - Fax:870-864-9934
Practice Address - Street 1:100 HARGETT DR
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-6521
Practice Address - Country:US
Practice Address - Phone:870-881-9301
Practice Address - Fax:870-864-9934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR00078251S00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health