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General NPI Number Information
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NPI Number | 1497220255
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Entity Type | Organization
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Legal Business Name | 8900 JFK, LLC
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Dates
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Enumeration Date | 10/09/2018
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 8900 HIGHWAY 107
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City | SHERWOOD
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State | AR
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Zip | 72120
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Country | US
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Telephone | 501-819-6816
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Fax | 501-392-6027
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Provider Business Mailing Address
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Address Line | 8900 HIGHWAY 107
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City | SHERWOOD
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State | AR
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Zip | 72120-2932
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP
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Name | RACHEL K NORWOOD
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Credential |
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Telephone | 501-224-0846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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