Organization
EAGLECREST RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HERNANDEZ LMFT (CEO)
(949) 813-5161
Entity
Organization
Contact information
Practice address
1101 SW COVENTRY BLVD, BENTONVILLE, AR 72712-4325
(479) 367-2691
Mailing address
1101 SW COVENTRY BLVD, BENTONVILLE, AR 72712-4325
(479) 367-2691
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/07/2019
Last updated
09/02/2021
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