Organization Name: | MAXUS INC. |
NPI Number: | 1104078997 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TED SUHL (CEO) |
Mailing Address: | 204 Frankie Lane White Hall |
State: | AR US |
Postal Code: | 716023067 |
Phone Number: | 8702472305 |
Fax Number: | 8702472330 |
NPI Enumeration Date: | 10/13/2008 |
NPI Last Update Date: | 07/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |