Healthcare Provider Details

I. General information

NPI: 1245453455
Provider Name (Legal Business Name): SPARKMAN LEARNING CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 PORTER
SPARKMAN AR
71763-0173
US

IV. Provider business mailing address

PO BOX 173
SPARKMAN AR
71763-0173
US

V. Phone/Fax

Practice location:
  • Phone: 870-678-2301
  • Fax: 870-678-2887
Mailing address:
  • Phone: 870-678-2301
  • Fax: 870-678-2887

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: MR. JESSIE CARTER
Title or Position: CHIEF OPERATIONS OFFICER
Credential: B.A., C.C.M., S.C.
Phone: 870-678-2301