Provider Demographics
NPI:1457609869
Name:ARKANSAS BEHAVIORAL CENTER (ABC), LLC
Entity Type:Organization
Organization Name:ARKANSAS BEHAVIORAL CENTER (ABC), LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KRAMEELAH
Authorized Official - Middle Name:MARSHAE
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:501-960-5779
Mailing Address - Street 1:9101 KANIS RD
Mailing Address - Street 2:#201
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6456
Mailing Address - Country:US
Mailing Address - Phone:501-960-5779
Mailing Address - Fax:501-537-0176
Practice Address - Street 1:9101 KANIS RD
Practice Address - Street 2:#201
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6456
Practice Address - Country:US
Practice Address - Phone:501-960-5779
Practice Address - Fax:501-537-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR05-13P251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health