Organization
VINE AND ROOT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SLADE HICKMON (AUTHORIZED OFFICIAL)
(501) 729-1700
Entity
Organization
Contact information
Practice address
915 E BEEBE CAPPS EXPY, SEARCY, AR 72143-6865
(015) 827-0989
Mailing address
915 E BEEBE CAPPS EXPY, SEARCY, AR 72143-6865
(501) 729-1700
(877) 310-6350
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
04/04/2023
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