| Hope House Branch | |
|
1506 Mary Kay Blvd. Benton AR 72015-8909 | |
| (501) 315-3344 | |
| Not Available |
| Full Name | Hope House Branch |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1506 Mary Kay Blvd., Benton, Arkansas |
| Authorized Official Name and Position | Rolando Garcia (CFO) |
| Authorized Official Contact | 5013153344 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hope House Branch Po Box 1589 Benton AR 72018-1589 Ph: (501) 315-3344 | Hope House Branch 1506 Mary Kay Blvd. Benton AR 72015-8909 Ph: (501) 315-3344 |
| NPI Number | 1285884239 |
|---|---|
| Provider Enumeration Date | 09/26/2008 |
| Last Update Date | 08/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285884239 | NPI | - | NPPES |
| 116374726 | Medicaid | AR | |
| 171624526 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Arkansas) | Primary |
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