Healthcare Provider Details

I. General information

NPI: 1780709501
Provider Name (Legal Business Name): NEWTON COUNTY SPECIAL SERVICE CORP., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 WEST CLARK STREET
JASPER AR
72641-0528
US

IV. Provider business mailing address

PO BOX 528
JASPER AR
72641-0528
US

V. Phone/Fax

Practice location:
  • Phone: 870-446-2682
  • Fax: 870-446-5142
Mailing address:
  • Phone: 870-446-2682
  • Fax: 870-446-5142

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: MRS. SHERRY R CAMPBELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 870-446-2682