RIVENDELL BEHAVIORAL HEALTH SERVICES OF AR (UHS OF BENTON, INC.) NPI 1386810604

Clinic/Center (Adolescent and Children Mental Health) in Marianna, AR

NPI 1386810604 Organization Clinic/Center Adolescent and Children Mental Health

About RIVENDELL BEHAVIORAL HEALTH SERVICES OF AR (UHS OF BENTON, INC.)

Rivendell Behavioral Health Services Of Ar (uhs Of Benton, Inc.) is a provider established in Marianna, Arkansas specializing in clinic/center (adolescent and children mental health) . The NPI number of Rivendell Behavioral Health Services Of Ar (uhs Of Benton, Inc.) is 1386810604 and was assigned on May 2008. The practitioner's primary taxonomy code is 261QM0855X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Rivendell Behavioral Health Services Of Ar. The authorized official of this NPI record is Mr. Scott Williams (Ceo)

NPI

1386810604

Provider NameRIVENDELL BEHAVIORAL HEALTH SERVICES OF AR (UHS OF BENTON, INC.)
Provider Location Address278 S FLORIDA ST MARIANNA, AR 72360
Provider Mailing Address278 S FLORIDA ST MARIANNA, AR 72360
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameRIVENDELL BEHAVIORAL HEALTH SERVICES OF AR
Other Name TypeDoing Business As (3)
Enumeration Date05-06-2008
Last Update Date05-06-2008


Primary Taxonomy

Taxonomy Code261QM0855X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationAdolescent and Children Mental Health
Taxonomy DescriptionAn entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.

Business Address

RIVENDELL BEHAVIORAL HEALTH SERVICES OF AR
278 S FLORIDA ST
MARIANNA, AR
ZIP 72360
Phone: (501) 316-1255
Fax: (501) 794-0908

Get Directions


Mailing Address

RIVENDELL BEHAVIORAL HEALTH SERVICES OF AR
278 S FLORIDA ST
MARIANNA, AR
ZIP 72360
Phone: (501) 316-1255
Fax: (501) 794-0908



Authorized Official

Authorized Official NameMR. SCOTT WILLIAMS
Authorized Official TitleCEO
Authorized Official Phone(501) 316-1255

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthNo

Taxonomy Description: an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
167272526MEDICAID (05)AR

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.