JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES NPI 1013461987

NPI Information

NPI: 1013461987
Provider Name: JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 04D1001560

Address:
2304 W 29TH AVE
PINE BLUFF, AR
ZIP 71603
Phone: (870) 247-5222
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JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES is a rehabilitation and substance use disorder clinic center in Pine Bluff, AR. JEFFERSON COMPREHENSIVE COUNSELING ASSOCIATES NPI is 1013461987. The provider is registered as an organization entity type.

The provider's business location address is:

2304 W 29TH AVE
PINE BLUFF, AR
ZIP 71603-005
Phone: (870) 247-5222
Fax: (870) 671-4847

The provider's authorized official is Scott Aaron Mabry .
The authorized official title is Clinical Director and has the following contact phone number (870) 247-5222.

The CLIA number assigned to this NPI record is 04D1001560 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/9/2016 and was last updated on 8/9/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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