| Ka Legacy Inc | |
|
103 W Fleeman Manila AR 72442 | |
| (870) 919-6585 | |
| Not Available |
| Full Name | Ka Legacy Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 103 W Fleeman, Manila, Arkansas |
| Authorized Official Name and Position | Tonya Grissom-tatroe (CEO) |
| Authorized Official Contact | 8709196585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ka Legacy Inc 103 W Fleeman Box 835 Manila AR 72442 Ph: (870) 919-6585 | Ka Legacy Inc 103 W Fleeman Manila AR 72442 Ph: (870) 919-6585 |
| NPI Number | 1174396980 |
|---|---|
| Provider Enumeration Date | 11/02/2023 |
| Last Update Date | 11/02/2023 |
| Certification Date | 11/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174396980 | NPI | - | NPPES |
| 429713402 | Other | AR | BCBS |
| 429713402 | Other | AR | UNITED HEALTH |
Delta Behavioral Health, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 603 W Fleeman Ste 4, Manila, AR 72442 Phone: 870-570-0358 Fax: 870-570-0359 |