Basic Information
| Provider Information | |||||||||
| NPI: | 1215052485 | ||||||||
| EntityType: | 2 | ||||||||
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| 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: | 1100 BOB COURTWAY DR | ||||||||
| Address2: | SUITE 9 | ||||||||
| City: | CONWAY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720324766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013285525 | ||||||||
| FaxNumber: | 5013285342 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2007 | ||||||||
| LastUpdateDate: | 07/31/2013 | ||||||||
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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 | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.