Provider Demographics
NPI:1639293491
Name:DEPARTMENT OF HEALTH AND HUMAN SERVICES
Entity Type:Organization
Organization Name:DEPARTMENT OF HEALTH AND HUMAN SERVICES
Other - Org Name:NORTHWEST REGION MATERNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:S
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-661-2859
Mailing Address - Street 1:P.O. BOX 1437
Mailing Address - Street 2:SLOT H-40
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72203
Mailing Address - Country:US
Mailing Address - Phone:501-661-2859
Mailing Address - Fax:501-661-2691
Practice Address - Street 1:27 WEST TOWNSHIP
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703
Practice Address - Country:US
Practice Address - Phone:479-675-2593
Practice Address - Fax:479-675-5852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare