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THE MENTAL FITNESS CENTER OF THE OZARKS,INC

Clinical Neuropsychologist

Harrison, Arkansas

Provider NPI: 1588672638

Organization Information:
Organization Name:  THE MENTAL FITNESS CENTER OF THE OZARKS,INC
Organization is not Subpart
Authorized Official:  STEPHEN ROBERT HARRIS  PRESIDENT  870-5772830

Practice Location:
715 W SHERMAN AVE STE F HARRISON, AR 72601 US
Tel: 870-577-2830  Fax: 871-741-3457

Business Mailing Address:
128 SAINT ANDREWS CIR  HIDEAWAY, TX 75771 US
Tel: --  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
AR76 19P

Other Provider Identifiers:

IssuerNumberStateType
101734719AR05
BLUE CROSS IDENTIFIER56201AR01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS AR - Page 1



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