Organization
BEHAVIORAL HEALTH SERVICES OF WEST MEMPHIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRILL VESSELOV (OWNER)
(561) 635-2400
Entity
Organization
Contact information
Practice address
410 S AVALON ST, WEST MEMPHIS, AR 72301-4183
(561) 635-2400
Mailing address
2925 10TH AVE N, PALM SPRINGS, FL 33461-3000
(561) 635-2400
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
283Q00000X
Psychiatric Hospital
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
02/11/2025
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