Organization
YOUTH BRIDGE
Active
Other names
Youth Bridge
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN HOKE (MHP)
(479) 575-9471
Entity
Organization
Contact information
Practice address
5327 CRESTWOOD ST, HARRISON, AR 72601-9292
(870) 688-9651
Mailing address
5327 CRESTWOOD ST, HARRISON, AR 72601-9292
(870) 688-9651
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
171M00000X
AR
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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