Provider Demographics
NPI:1720468937
Name:VANARK BEHAVIORAL MANAGEMENT, INC.
Entity Type:Organization
Organization Name:VANARK BEHAVIORAL MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:BSW,ICADC,CSS
Authorized Official - Phone:606-886-9989
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-0092
Mailing Address - Country:US
Mailing Address - Phone:606-886-9989
Mailing Address - Fax:606-889-8603
Practice Address - Street 1:207 W COURT ST
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-7732
Practice Address - Country:US
Practice Address - Phone:606-886-9989
Practice Address - Fax:606-889-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY810154101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty