Provider Demographics
NPI:1902372774
Name:HOMETOWN BEHAVIORAL HEALTH SERVICES OF ARKANSAS, INC
Entity Type:Organization
Organization Name:HOMETOWN BEHAVIORAL HEALTH SERVICES OF ARKANSAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRONDZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-886-1333
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:HOXIE
Mailing Address - State:AR
Mailing Address - Zip Code:72433-0299
Mailing Address - Country:US
Mailing Address - Phone:870-886-1333
Mailing Address - Fax:870-886-1334
Practice Address - Street 1:353 E 8TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4423
Practice Address - Country:US
Practice Address - Phone:870-701-5141
Practice Address - Fax:870-701-5177
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMETOWN BEHAVIORAL HEALTH SERVICES OF ARKANSAS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-19
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty