Healthcare Provider Details

I. General information

NPI: 1962407759
Provider Name (Legal Business Name): OUACHITA ENRICHMENT CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 06/03/2024
Certification Date: 06/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 W WASHINGTON ST
CAMDEN AR
71701-3958
US

IV. Provider business mailing address

206 W WASHINGTON ST
CAMDEN AR
71701-3958
US

V. Phone/Fax

Practice location:
  • Phone: 870-836-3056
  • Fax: 870-498-8838
Mailing address:
  • Phone: 870-836-3056
  • Fax: 870-498-8838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateAR

VIII. Authorized Official

Name: MISS CRYSTAL CHANDLER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 870-836-3056