Provider Demographics
NPI:1679104392
Name:OUACHITA REGIONAL COUNSELING & MENTAL HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:OUACHITA REGIONAL COUNSELING & MENTAL HEALTH CENTER, INC.
Other - Org Name:OUACHITA BEHAVIORAL HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHERRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-620-5119
Mailing Address - Street 1:125 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6478
Mailing Address - Country:US
Mailing Address - Phone:501-620-5119
Mailing Address - Fax:501-620-5254
Practice Address - Street 1:128 S GEORGE STREET
Practice Address - Street 2:
Practice Address - City:MOUNT IDA
Practice Address - State:AR
Practice Address - Zip Code:71957-9421
Practice Address - Country:US
Practice Address - Phone:870-867-2147
Practice Address - Fax:870-867-2164
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OUACHITA REGIONAL COUNSELING & MENTAL HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)