| Psycamore, LLC | |
|
6323 Ranch Dr Little Rock AR 72223-4623 | |
| (601) 939-5993 | |
| Not Available |
| Full Name | Psycamore, LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 6323 Ranch Dr, Little Rock, Arkansas |
| Authorized Official Name and Position | Sudhakar Madakasira (CEO/MEDICAL DIRECTOR) |
| Authorized Official Contact | 6019395993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psycamore, LLC 2540 Flowood Dr Flowood MS 39232-9362 Ph: (601) 939-5993 | Psycamore, LLC 6323 Ranch Dr Little Rock AR 72223-4623 Ph: (601) 939-5993 |
| NPI Number | 1588024574 |
|---|---|
| Provider Enumeration Date | 03/03/2016 |
| Last Update Date | 03/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588024574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Arkansas) | Primary |
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