Organization
ASCENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SHAN REANN HAMILTON LEAD EDCT (LEAD EDCT)
(870) 933-9528
Entity
Organization
Contact information
Practice address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 933-9528
Mailing address
806 GLENDALE, JONESBORO, AR 72401
(870) 933-9528
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104100000
—
AR
Enumeration date
09/20/2012
Last updated
09/20/2012
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