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General NPI Number Information
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NPI Number | 1417072208
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Entity Type | Organization
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Legal Business Name | VAN BUREN COUNTY SPECIAL SCHOOL
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3707 HWY 95 EAST
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City | CHOCTAW
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State | AR
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Zip | 72028-0039
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Country | US
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Telephone | 501-745-4580
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Fax | 501-745-5919
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Provider Business Mailing Address
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Address Line | PO BOX 39
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City | CHOCTAW
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State | AR
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Zip | 72028-0039
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Country | US
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Telephone | 501-745-4580
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Fax | 501-745-5919
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. NEIL ALLEN WILKINS JR.
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Credential |
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Telephone | 501-745-4580
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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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