Organization
MAINLINE HEALTH SYSTEMS, INC
Active
Other names
Warren High School BH
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ALLAN NICHOLS (CEO)
(870) 942-3000
Entity
Organization
Contact information
Practice address
931 N MYRTLE ST, BUILDING D, WARREN, AR 71671-2028
(870) 226-6754
(870) 226-7925
Mailing address
342 HIGHWAY 425 S, MONTICELLO, AR 71655-4612
(870) 942-3000
(870) 942-3005
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
—
—
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300240749
—
AR
Enumeration date
08/24/2022
Last updated
03/20/2026
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