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General NPI Number Information
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NPI Number | 1114050036
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Entity Type | Organization
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Legal Business Name | CHICOT COUNTY EARLY CHILDHOOD CENTER
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 09/18/2007
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Provider Practice Location Address
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Address Line | 422 ANNEX ST
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-1809
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Country | US
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Telephone | 870-265-4191
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Fax | 870-265-4192
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Provider Business Mailing Address
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Address Line | PO BOX 801
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City | LAKE VILLAGE
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State | AR
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Zip | 71653-0801
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Country | US
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Telephone | 870-265-4191
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Fax | 870-265-4192
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. EVA J SYKES
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Credential |
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Telephone | 870-265-4191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 11418
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License Number State | AR
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