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Antwain Harris, Recovery Assistant

Case Manager/Care Coordinator in Conway, AR. Individual provider (NPI-1).

NPI number1114359486
StatusActive
Last updated in NPPESAug 8, 2013

Details

NPI
1114359486
Entity type
Individual (NPI-1)
Name
Antwain Harris
Credential
Recovery Assistant
Sex
Male
Sole proprietor
No
Enumeration date
Aug 8, 2013
Last updated
Aug 8, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care Coordinator–ARYes

Practice location

132 Lower Ridge Rd
Conway, AR 72032-8518

Phone 501-548-9905

Mailing address

Po Box 1589
Benton, AR 72018-1589

Phone 501-315-3344

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