# ARKANSAS DEPARTMENT OF HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ADH Southeast Region EPSDT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205154044
- **Authorized official:** MS. TERRI S WRIGHT (AGENCY PROGRAM COORDINATOR)
- **Authorized official phone:** (501) 661-2859

## Contact information

- **Practice address:** 1742 HWY 65 AND 82 SOUTH, LAKE VILLAGE, AR 71653
- **Practice address phone:** (870) 265-2236
- **Practice address fax:** (870) 265-8001
- **Mailing address:** 4815 W MARKHAM ST, SLOT 40, LITTLE ROCK, AR 72205-3866
- **Mailing address phone:** (501) 661-2859
- **Mailing address fax:** (501) 661-2691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/04/2010
- **Last updated:** 05/04/2010