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General NPI Number Information
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NPI Number | 1467672162
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Entity Type | Organization
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Legal Business Name | PERRY COUNTY DAY SERVICE CENTER, INC.
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 115 SOUTH PINE STREET
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City | PERRYVILLE
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State | AR
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Zip | 72126
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Country | US
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Telephone | 501-889-5755
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Fax | 501-889-5688
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Provider Business Mailing Address
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Address Line | PO BOX 672
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City | PERRYVILLE
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State | AR
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Zip | 72126-0672
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Country | US
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Telephone | 501-889-5755
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Fax | 501-889-5688
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CHRISTY CAMPBELL
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Credential |
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Telephone | 501-889-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | AR
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