Organization
EXODUS.LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELRITA MAECHEL JOHNSON LCSW (CLINICAL DIRECTOR)
(501) 680-7644
Entity
Organization
Contact information
Practice address
3700 W 65TH ST, LITTLE ROCK, AR 72209-8552
(501) 680-7644
Mailing address
3700 W 65TH ST, LITTLE ROCK, AR 72209-8552
(501) 680-7644
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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