Organization
MAINLINE HEALTH SYSTEMS INC
Active
Other names
PORTLAND HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ALLAN NICHOLS (CEO)
(870) 942-3000
Entity
Organization
Contact information
Practice address
233 N MAIN ST, PORTLAND, AR 71663
(870) 737-2221
(855) 878-5991
Mailing address
342 HIGHWAY 425 S, MONTICELLO, AR 71655-4612
(870) 942-3000
(870) 942-3005
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117615749
—
AR
Enumeration date
06/05/2008
Last updated
03/23/2026
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