Provider Demographics
NPI:1871480046
Name:CET OF ARKANSAS LLC
Entity type:Organization
Organization Name:CET OF ARKANSAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-735-2588
Mailing Address - Street 1:1201 N MISSOURI ST STE A1
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-2621
Mailing Address - Country:US
Mailing Address - Phone:870-735-9838
Mailing Address - Fax:870-629-5179
Practice Address - Street 1:1201 N MISSOURI ST STE A1
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-2621
Practice Address - Country:US
Practice Address - Phone:870-735-2588
Practice Address - Fax:870-629-5179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty