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KENNETH BEAVER MHPP

>> Case Manager/Care Coordinator >> Other Service Providers

Registrant NPI Number: 1942572383

Individual Registrant:
 KENNETH  BEAVER MHPP
Gender: M
Sole Proprietor

Location and contact information for practice:
3399 FINCH RD  BISMARCK, AR 71929-7541 US
Tel: 501-663-5473  Fax: 501-801-1816

Contact information for business:
3399 FINCH RD  BISMARCK, AR 71929-7541 US
Tel: 501-663-5473  Fax: 501-801-1816

Registration Information:
NPI: 1942572383
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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