Basic Information
| Provider Information | |||||||||
| NPI: | 1194840363 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MAXUS INC. | ||||||||
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| OtherOrganizationName: | ARKANSAS COUNSELING ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1033 OLD BURR RD | ||||||||
| Address2: | |||||||||
| City: | WARM SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724789077 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8706471400 | ||||||||
| FaxNumber: | 8706472337 | ||||||||
| Practice Location | |||||||||
| Address1: | 4001 COMMERCIAL CENTER DRIVE | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | MARION | ||||||||
| State: | AR | ||||||||
| PostalCode: | 723642361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707354441 | ||||||||
| FaxNumber: | 8707355441 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 07/30/2013 | ||||||||
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| AuthorizedOfficialLastName: | SUHL | ||||||||
| AuthorizedOfficialFirstName: | TED | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8706471400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | AR | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.