Healthcare Provider Details

I. General information

NPI: 1164646543
Provider Name (Legal Business Name): KIDS FOR THE FUTURE OF PARKIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 LAKE
PARKIN AR
72373
US

IV. Provider business mailing address

PO BOX 66
WYNNE AR
72396-0066
US

V. Phone/Fax

Practice location:
  • Phone: 870-755-2737
  • Fax: 870-755-2740
Mailing address:
  • Phone: 870-755-2737
  • Fax: 870-755-2740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number23984
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number23984
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number23984
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number23984
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number23984
License Number StateAR
# 6
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number23984
License Number StateAR
# 7
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number23984
License Number StateAR
# 8
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number23984
License Number StateAR
# 9
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number23984
License Number StateAR
# 10
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number23984
License Number StateAR

VIII. Authorized Official

Name: THOMAS HEISLER
Title or Position: OWNER
Credential: PH.D
Phone: 18707552737