# GENESIS MEDICAL CENTER

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

## Provider details

- **NPI number:** 1336932862
- **Authorized official:** QUANIKA S SIMPSON-JACKSON (ADMINISTRATOR)
- **Authorized official phone:** (702) 417-4702

## Contact information

- **Practice address:** 104 PARK PL, EUDORA, AR 71640-2661
- **Practice address phone:** (870) 355-9001
- **Mailing address:** 104 PARK PL, EUDORA, AR 71640-2661
- **Mailing address phone:** (870) 355-9001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106S00000X | Behavior Technician | — | NULL | — |
| 106S00000X | Behavior Technician | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QF0050X | Non-Surgical Family Planning Clinic/Center | — | NULL | — |
| 261QG0250X | Genetics Clinic/Center | — | NULL | — |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 05/27/2025
- **Last updated:** 05/27/2025