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Organization

DEPARTMENT OF HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERRI S WRIGHT BBA (AGENCY PROGRAM COORDINATOR)
(501) 661-2859
Entity
Organization

Contact information

Practice address
1501 DAWSON ROAD, FORREST CITY, AR 72236
(501) 661-2269
(501) 661-2855
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
146398730
AR
Enumeration date
03/28/2007
Last updated
07/02/2008
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