Organization
ARKANSAS DEPARTMENT OF HEALTH
Active
Other names
ADH Southeast Region EPSDT
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI S WRIGHT (AGENCY PROGRAM COORDINATOR)
(501) 661-2859
Entity
Organization
Contact information
Practice address
1742 HWY 65 AND 82 SOUTH, LAKE VILLAGE, AR 71653
(870) 265-2236
(870) 265-8001
Mailing address
4815 W MARKHAM ST, SLOT 40, LITTLE ROCK, AR 72205-3866
(501) 661-2859
(501) 661-2691
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181187002
—
AR
Enumeration date
05/04/2010
Last updated
05/04/2010
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