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General NPI Number Information
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NPI Number | 1316793748
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Entity Type | Organization
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Legal Business Name | ABC CHILDREN'S ACADEMY & DEVELOPMENTAL CENTER INC
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Dates
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Enumeration Date | 04/26/2024
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 1101 S ERIE AVE
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-6857
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Country | US
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Telephone | 479-968-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 820 E 4TH ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-5227
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Country | US
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Telephone | 479-567-5650
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Fax |
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | AMANDA FARMER
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Credential |
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Telephone | 479-567-5650
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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 |
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License Number State |
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