Organization
GENESIS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QUANIKA S SIMPSON-JACKSON (ADMINISTRATOR)
(702) 417-4702
Entity
Organization
Contact information
Practice address
104 PARK PL, EUDORA, AR 71640-2661
(870) 355-9001
Mailing address
104 PARK PL, EUDORA, AR 71640-2661
(870) 355-9001
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QF0050X
Non-Surgical Family Planning Clinic/Center
—
—
261QG0250X
Genetics Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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