Experience Counseling Clinic, INC.
Clinic/Center, Mental Health (Including Community Mental Health Center) in Benton, AR. Organization (NPI-2).
NPI number1053198283
StatusActive
Last updated in NPPESSep 11, 2023
Details
- NPI
- 1053198283
- Entity type
- Organization (NPI-2)
- Legal business name
- Experience Counseling Clinic, INC.
- Organization subpart
- No
- Enumeration date
- Sep 11, 2023
- Certification date
- Sep 11, 2023
- Last updated
- Sep 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
1209 Ferguson DrBenton, AR 72015-3596
Phone 870-470-5001
Mailing address
Po Box 932Hope, AR 71802-0932
Authorized official
Kimberly Moore
Owner/Coo
8704745001
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