Healthcare Provider Details

I. General information

NPI: 1891431300
Provider Name (Legal Business Name): PALMA ACADEMY OF LEARNING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2022
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 SOUTHPOINTE DR
PARAGOULD AR
72450-6238
US

IV. Provider business mailing address

5828 TERNCREST DR
LITHIA FL
33547-5876
US

V. Phone/Fax

Practice location:
  • Phone: 870-565-9776
  • Fax:
Mailing address:
  • Phone: 813-967-5706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. LARRY F WOLPERT JR.
Title or Position: OWNER
Credential:
Phone: 813-967-5706