Provider Demographics
NPI:1497993398
Name:UNITED METHODIST BEHAVIORAL HEALTH SYSTEMS, INC
Entity Type:Organization
Organization Name:UNITED METHODIST BEHAVIORAL HEALTH SYSTEMS, INC
Other - Org Name:HAZEN OUTPATIENT
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNDI
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-803-3388
Mailing Address - Street 1:1600 ALDERSGATE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6614
Mailing Address - Country:US
Mailing Address - Phone:501-661-0720
Mailing Address - Fax:501-325-7938
Practice Address - Street 1:477 N HAZEN AVE
Practice Address - Street 2:
Practice Address - City:HAZEN
Practice Address - State:AR
Practice Address - Zip Code:72064-8072
Practice Address - Country:US
Practice Address - Phone:501-661-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty