Organization
SOUTH ARKANSAS YOUTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATRINA LASHEY JACKSON (MHPP)
(870) 863-5153
Entity
Organization
Contact information
Practice address
300 THOMPSON AVE, EL DORADO, AR 71730-4569
(870) 863-5153
(870) 863-5154
Mailing address
300 THOMPSON AVE, EL DORADO, AR 71730-4569
(870) 863-5153
(870) 863-5154
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
MENTAL HEALTH PARAPROFESSIONAL
AR
Enumeration date
09/29/2010
Last updated
09/29/2010
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