Provider Demographics
NPI:1568081388
Name:SEAN'S CRISIS CENTER
Entity Type:Organization
Organization Name:SEAN'S CRISIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-412-5520
Mailing Address - Street 1:3305 MALLOY ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-4480
Mailing Address - Country:US
Mailing Address - Phone:501-412-5520
Mailing Address - Fax:
Practice Address - Street 1:3305 MALLOY ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-4480
Practice Address - Country:US
Practice Address - Phone:501-412-5520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE DAVIDSON HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-11
Last Update Date:2020-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty