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RUSSELL BORLAND MHPP
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1215186291
Individual Registrant: RUSSELL BORLAND MHPP
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
400 E HIGHWAY 43 HARRISON, AR 72601-6514 US
Tel: 870-391-3871 Fax: 870-391-3874
Tel: 870-391-3871 Fax: 870-391-3874
Contact information for business:
4253 N CROSSOVER RD FAYETTEVILLE, AR 72703-4593 US
Tel: 479-521-5731 Fax: 479-521-6520
Tel: 479-521-5731 Fax: 479-521-6520
Registration Information:
NPI: 1215186291
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
