Provider Demographics
NPI:1437390622
Name:SUPERIOR BEHAVIORAL OUTCOMES
Entity Type:Organization
Organization Name:SUPERIOR BEHAVIORAL OUTCOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:C. ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPE
Authorized Official - Phone:501-351-3176
Mailing Address - Street 1:PO BOX 2030
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71613-2030
Mailing Address - Country:US
Mailing Address - Phone:501-351-3176
Mailing Address - Fax:
Practice Address - Street 1:601 S EAGLE ST
Practice Address - Street 2:#18
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-6787
Practice Address - Country:US
Practice Address - Phone:501-351-3176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health