Organization Name: | ASCENT ACQUISITIONS CORP-PSC |
NPI Number: | 1124151220 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HOLLY ALLGOOD (BILLING SPECIALIST) |
Mailing Address: | 1510 Byrum Rd Blytheville |
State: | AR US |
Postal Code: | 723158033 |
Phone Number: | 8705322600 |
Fax Number: | 8705329484 |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 04/12/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC2200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical Child & Adolescent |
Taxonomy Definition: |