Provider Demographics
NPI:1154594380
Name:BHC PINNACLE POINTE HOSPITAL
Entity type:Organization
Organization Name:BHC PINNACLE POINTE HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:UR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-381-2001
Mailing Address - Street 1:910 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3327
Mailing Address - Country:US
Mailing Address - Phone:501-381-2001
Mailing Address - Fax:501-381-2005
Practice Address - Street 1:1933 SHOEMAKER RD STE D
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-3000
Practice Address - Country:US
Practice Address - Phone:870-917-2171
Practice Address - Fax:870-917-2161
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BHC PINNACLE POINTE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-09
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR202112526Medicaid