Provider Demographics
NPI:1588212831
Name:DARDANELLE HOSPITAL YELL COUNTY
Entity Type:Organization
Organization Name:DARDANELLE HOSPITAL YELL COUNTY
Other - Org Name:DARDANELLE REGIONAL OUTPATIENT BEHAVIORAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE ASSOCIATE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COTHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-745-2122
Mailing Address - Street 1:200 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-3802
Mailing Address - Country:US
Mailing Address - Phone:479-229-6192
Mailing Address - Fax:479-229-6182
Practice Address - Street 1:215 N 4TH ST
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-3713
Practice Address - Country:US
Practice Address - Phone:479-229-6192
Practice Address - Fax:479-229-6182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty