Organization
CB KING UAM CAMPUS
Active
Organization
CB KING UAM CAMPUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY J GREGORY (OFFICE MANAGER)
(870) 222-4544
Entity
Organization
Contact information
Practice address
1711 EAST ASH STREET, MCGEHEE, AR 71654
(870) 222-6589
(870) 222-3361
Mailing address
1711 EAST ASH STREET, MCGEHEE, AR 71654
(870) 222-6589
(870) 222-3361
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
01923
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180540724
—
AR
Enumeration date
04/15/2010
Last updated
04/15/2010
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