Organization
VETERANS ADMINISTRATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY COX (CREDENTIALING PROGRAM SUPPORT)
(501) 257-1484
Entity
Organization
Contact information
Practice address
6390 CASH MOUNTAIN RD, MALVERN, AR 72104-9137
(501) 939-2100
Mailing address
6390 CASH MOUNTAIN RD, MALVERN, AR 72104-9137
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
R43129
AR
Other
Enumeration date
04/01/2007
Last updated
08/22/2020
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