| Bokker Enterprises, Inc. | |
|
2012 Hwy 62-412 Highland AR 72542-9477 | |
| (870) 856-3337 | |
| (870) 856-3334 |
| Full Name | Bokker Enterprises, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2012 Hwy 62-412, Highland, Arkansas |
| Authorized Official Name and Position | Lon Paul Bokker (CEO) |
| Authorized Official Contact | 8708563337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bokker Enterprises, Inc. Po Box 176 Cherokee Village AR 72525-0176 Ph: (870) 856-3337 | Bokker Enterprises, Inc. 2012 Hwy 62-412 Highland AR 72542-9477 Ph: (870) 856-3337 |
| NPI Number | 1508040262 |
|---|---|
| Provider Enumeration Date | 12/18/2007 |
| Last Update Date | 10/24/2019 |
| Medicare PECOS PAC ID | 8628153194 |
|---|---|
| Medicare Enrollment ID | O20080307000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508040262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | James Acup |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437625274 PECOS PAC ID: 0042564494 Enrollment ID: I20181121001384 |
| Provider Name | Tracy Polly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629426267 PECOS PAC ID: 2365782513 Enrollment ID: I20190326000211 |
| Provider Name | Jeremy Stuntz-christian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205013893 PECOS PAC ID: 9436487618 Enrollment ID: I20240209000501 |
| Provider Name | Lon Paul Bokker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518992163 PECOS PAC ID: 7719957547 Enrollment ID: I20240209002166 |
| Provider Name | Robin Stuntz-christian |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629255120 PECOS PAC ID: 1153761432 Enrollment ID: I20240503000895 |
| Provider Name | Aric Oneil Bokker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1679029201 PECOS PAC ID: 1759722762 Enrollment ID: I20240508002125 |
| Provider Name | Alana Ruth Walls |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285908616 PECOS PAC ID: 4587108782 Enrollment ID: I20240628001670 |