Provider Demographics
NPI:1356182687
Name:ALLEN MENTAL HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ALLEN MENTAL HEALTH SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:501-462-5789
Mailing Address - Street 1:1401 E BROADWAY ST STE 23
Mailing Address - Street 2:
Mailing Address - City:MORRILTON
Mailing Address - State:AR
Mailing Address - Zip Code:72110-3708
Mailing Address - Country:US
Mailing Address - Phone:501-462-5789
Mailing Address - Fax:501-285-9115
Practice Address - Street 1:1401 E BROADWAY ST STE 23
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110-3708
Practice Address - Country:US
Practice Address - Phone:501-462-5789
Practice Address - Fax:501-285-9115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty