Provider Demographics
NPI:1578844221
Name:NASH THERAPEUTIC SERVICES, LLC
Entity Type:Organization
Organization Name:NASH THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CLINICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:NASH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-500-2113
Mailing Address - Street 1:628 W BROADWAY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:N LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-5545
Mailing Address - Country:US
Mailing Address - Phone:501-500-2111
Mailing Address - Fax:501-244-9999
Practice Address - Street 1:4806 RIXIE RD
Practice Address - Street 2:
Practice Address - City:N LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-1537
Practice Address - Country:US
Practice Address - Phone:501-500-2111
Practice Address - Fax:501-244-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-07
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health