Organization Name: | MARKALLEN BEHAVIORAL HEALTH SYSTEM, INC. |
NPI Number: | 1164550760 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEVEN ROBERT JENKINS (PRESIDENT, THERAPIST) |
Mailing Address: | 108 S Jefferson St Dewitt |
State: | AR US |
Postal Code: | 720421929 |
Phone Number: | 8709460158 |
Fax Number: | 8709460159 |
NPI Enumeration Date: | 03/02/2007 |
NPI Last Update Date: | 01/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | P0111048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |