| Randolph's Professional Treatment Services, Pllc | |
|
6801 Isaacs Orchard Rd Ste. 215 Springdale AR 72762-6545 | |
| (479) 725-3813 | |
| (479) 419-4046 |
| Full Name | Randolph's Professional Treatment Services, Pllc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 6801 Isaacs Orchard Rd, Springdale, Arkansas |
| Authorized Official Name and Position | Joseph Brannon Randolph (PRESIDENT/CEO) |
| Authorized Official Contact | 4797253813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Randolph's Professional Treatment Services, Pllc 6801 Isaacs Orchard Rd Ste. 215 Springdale AR 72762-6545 Ph: (479) 725-3813 | Randolph's Professional Treatment Services, Pllc 6801 Isaacs Orchard Rd Ste. 215 Springdale AR 72762-6545 Ph: (479) 725-3813 |
| NPI Number | 1508183013 |
|---|---|
| Provider Enumeration Date | 04/23/2010 |
| Last Update Date | 12/10/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508183013 | NPI | - | NPPES |
| 181106719 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | P0309038 (Arkansas) | Primary |
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