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Organization
WATCH MOUNTAIN CLINIC
Active
Organization
WATCH MOUNTAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA L CHAMBERS (OWNER OF ENTITY)
(479) 957-9718
Entity
Organization
Contact information
Practice address
601 MAPLE AVE, MENA, AR 71953-3227
(479) 216-1172
Mailing address
601 MAPLE AVE, MENA, AR 71953-3227
(479) 957-9718
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/20/2020
Last updated
11/17/2020
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