Organization
ACTSS A COMMON THREAD SUPPORTIVE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY D FLAKE QMHP-C,A (PRESIDENT/DIRECTOR)
(615) 347-3115
Entity
Organization
Contact information
Practice address
821 N 10TH ST, FORT SMITH, AR 72901-1505
(479) 763-1305
Mailing address
4288 CARTEGENA WAY, LAS VEGAS, NV 89121-6504
(615) 347-3115
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YS0200X
School Counselor
—
—
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
02/19/2020
Last updated
05/04/2022
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