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NPI Code Detail

MEDICARE: DREW COUNTY DEVELOPMENTAL DISABILITY COUNCIL, INC.

MEDICARE: DREW COUNTY DEVELOPMENTAL DISABILITY COUNCIL, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2347B00000XBus
3251B00000XCase Management Agency

General Provider Information

NPI Number : 1134347818
Entity Type Code : Organization
Provider Name (Legal Business Name) : DREW COUNTY DEVELOPMENTAL DISABILITY COUNCIL, INC.
Provider Business Mailing Address
First Line : PO BOX 359
Second Line :
City : MONTICELLO
State : AR
Zip : 71657-0359
Country : US
Telephone Number : 870-367-6825
Fax Number : 870-367-0140
Provider Business Practice Location Address
First Line : 168 W COLLEGE AVE
Second Line :
City : MONTICELLO
State : AR
Zip : 71655
Country : US
Telephone Number : 870-367-6825
Fax Number : 870-367-0140
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. SANDY PATRICK
Credential :
Telephone Number : 870-367-6825
Provider Enumeration Date : 04/20/2007
Last Update Date : 09/11/2025

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Directions to “DREW COUNTY DEVELOPMENTAL DISABILITY COUNCIL, INC. ” Practice Location

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