NPI 1912314972

Youthbridge

Organisation Mental Illness Community Based Residential Treatment Facility Fayettville, AR

Practice location

Address: 2153 E Joyce Blvd, Fayettville, AR 72703
Phone: (479) 575-9471
Mailing address: 2153 E Joyce Blvd, Fayetteville, AR 72703-4714

Authorised official

Name: Marilyn Hoke
Title: Human Resources
Phone: (479) 575-9471

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 171MOOOOOX (AR)

Other Community Based Residential Treatment Facility, Mental Illness providers in Arkansas →

Registry record

NPI: 1912314972
Entity type: Organization
NPI issued: 22 Jul 2014
Record last updated: 22 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.