Basic Information
| Provider Information | |||||||||
| NPI: | 1649542366 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BHC PINNACLE POINTE HOSPITAL, INC. | ||||||||
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| OtherOrganizationName: | THE POINTE OUTPATIENT BEHAVIORAL HEALTH SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 FRANKIE LN | ||||||||
| Address2: | |||||||||
| City: | WHITE HALL | ||||||||
| State: | AR | ||||||||
| PostalCode: | 716022685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702473588 | ||||||||
| FaxNumber: | 8702472072 | ||||||||
| Practice Location | |||||||||
| Address1: | 109 FRANKIE LN | ||||||||
| Address2: | |||||||||
| City: | WHITE HALL | ||||||||
| State: | AR | ||||||||
| PostalCode: | 71602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702473588 | ||||||||
| FaxNumber: | 8702472072 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2012 | ||||||||
| LastUpdateDate: | 09/06/2018 | ||||||||
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| AuthorizedOfficialLastName: | FRAZIER | ||||||||
| AuthorizedOfficialFirstName: | SHANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5012233322 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | N | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | 261QM0855X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 190121526 | 05 | AR | MEDICAID |