Organization
CONWAY COUNTY COMMUNITY SERVICE INC.
Active
Other names
Community Service Inc. - Russellville
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LYNN WHEAT (PA/CREDENTIALING CLERK)
(501) 354-4589
Entity
Organization
Contact information
Practice address
1505 S OSWEGO AVE, RUSSELLVILLE, AR 72802-2673
(479) 967-3370
(479) 967-2775
Mailing address
1505 S OSWEGO AVE, RUSSELLVILLE, AR 72802-2673
(479) 967-3370
(479) 967-2775
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/15/2009
Last updated
03/03/2021
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