| Organization Name: | NORTHEAST ARKANSAS COMMUNITY MENTAL HEALTH CENTER |
| NPI Number: | 1043461510 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DONNIE LYERLY (PROVIDER CREDENTIALING) |
| Mailing Address: | 209 S Lockard St Blytheville |
| State: | AR US |
| Postal Code: | 723152541 |
| Phone Number: | 8707632139 |
| Fax Number: | 8709724911 |
| NPI Enumeration Date: | 10/02/2008 |
| NPI Last Update Date: | 12/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |