| Crutchfield House Llc | |
|
17706 I 30 Ste 3 Benton AR 72019-2930 | |
| (501) 860-4460 | |
| Not Available |
| Full Name | Crutchfield House Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 17706 I 30 Ste 3, Benton, Arkansas |
| Authorized Official Name and Position | Holly Crutchfield (OWNER/MENTAL HEALTH PROFESSIONAL) |
| Authorized Official Contact | 5018604460 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crutchfield House Llc 1210 Oxford Ave Benton AR 72019-2664 Ph: () - | Crutchfield House Llc 17706 I 30 Ste 3 Benton AR 72019-2930 Ph: (501) 860-4460 |
| NPI Number | 1215498464 |
|---|---|
| Provider Enumeration Date | 03/29/2019 |
| Last Update Date | 03/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215498464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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