Individual
MR. JIMI HENDERSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RECOVERY ASSISTANT
Contact information
Practice address
132 LOWER RIDGE RD, CONWAY, AR 72032-8518
(501) 548-9905
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/24/2015
Last updated
11/08/2021
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