Organization
YOUTHBRIDGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARILYN HOKE (HUMAN RESOURCES)
(479) 575-9471
Entity
Organization
Contact information
Practice address
2153 E JOYCE BLVD, FAYETTVILLE, AR 72703
(479) 575-9471
Mailing address
2153 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4714
(479) 575-9471
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
171MOOOOOX
AR
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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