| Our Brother's Keeper Wellness Organization | |
|
7101 W 12th St Ste 200i Little Rock AR 72204-2404 | |
| (501) 647-1042 | |
| Not Available |
| Full Name | Our Brother's Keeper Wellness Organization |
|---|---|
| Speciality | Case Management |
| Location | 7101 W 12th St Ste 200i, Little Rock, Arkansas |
| Authorized Official Name and Position | Tanya Maryie Bell-brooks (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5014122268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Our Brother's Keeper Wellness Organization Po Box 46346 Little Rock AR 72214-6346 Ph: (501) 647-1042 | Our Brother's Keeper Wellness Organization 7101 W 12th St Ste 200i Little Rock AR 72204-2404 Ph: (501) 647-1042 |
| NPI Number | 1720751373 |
|---|---|
| Provider Enumeration Date | 07/29/2021 |
| Last Update Date | 07/29/2021 |
| Certification Date | 07/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720751373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
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