| Conway County Community Service, Inc | |
|
804 W Freeman Ave Berryville AR 72616-3106 | |
| (870) 280-3468 | |
| Not Available |
| Full Name | Conway County Community Service, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 804 W Freeman Ave, Berryville, Arkansas |
| Authorized Official Name and Position | Angela Lynn Wheat (PA/CREDENTIALING CLERK) |
| Authorized Official Contact | 5013544589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Conway County Community Service, Inc Po Box 679 Morrilton AR 72110-0679 Ph: (501) 354-4589 | Conway County Community Service, Inc 804 W Freeman Ave Berryville AR 72616-3106 Ph: (870) 280-3468 |
| NPI Number | 1699360420 |
|---|---|
| Provider Enumeration Date | 03/03/2021 |
| Last Update Date | 03/03/2021 |
| Certification Date | 03/03/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699360420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Conway County Community Service, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 605 Eureka Ave Ste C, Berryville, AR 72616 Phone: 870-929-6023 Fax: 870-505-2003 | |
Rebecca Zeleny Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 702 Eureka Street, Berryville, AR 72616 Phone: 479-981-0060 |