# CRUTCHFIELD HOUSE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215498464
- **Authorized official:** MRS. HOLLY CRUTCHFIELD LCSW (OWNER/MENTAL HEALTH PROFESSIONAL)
- **Authorized official phone:** (501) 860-4460

## Contact information

- **Practice address:** 17706 I 30 STE 3, BENTON, AR 72019-2930
- **Practice address phone:** (501) 860-4460
- **Mailing address:** 1210 OXFORD AVE, BENTON, AR 72019-2664

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/29/2019
- **Last updated:** 03/29/2019