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Organization

1621 E 42 LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EDWARD V HOLMAN (CEO/PRESIDENT)
(501) 224-0846
Entity
Organization

Contact information

Practice address
1623 E 42ND ST, TEXARKANA, AR 71854-1894
(870) 772-0689
Mailing address
10 SHACKLEFORD PLZ STE 102, LITTLE ROCK, AR 72211-1886
(501) 224-0846
(501) 224-0834

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
02/10/2025
Last updated
02/11/2026
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