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Organization
LITTLE ROCK COMMUNITY MENTAL HEALTH CENTER
Active
Organization
LITTLE ROCK COMMUNITY MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE M LEWIS LPN (LPN)
(501) 686-9300
Entity
Organization
Contact information
Practice address
1100 N. UNIVERSITY, LITTLE ROCK, AR 72205
(501) 686-9300
Mailing address
1100 N UNIVERSITY AVE, LITTLE ROCK, AR 72207-6343
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L049916
AR
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
LO49916
AR
Other
Enumeration date
06/27/2018
Last updated
07/06/2018
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