=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841416716
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANK C. STEUDLEIN LEARNING CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2007
-----------------------------------------------------
Last Update Date | 06/17/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 207 BALFOUR RD
-----------------------------------------------------
City | WEST MEMPHIS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72301-1701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-733-9950
-----------------------------------------------------
Fax | 870-733-9966
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 207 BALFOUR RD PO BOX 2627
-----------------------------------------------------
City | WEST MEMPHIS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72301-1701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-733-9950
-----------------------------------------------------
Fax | 870-733-9966
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | MRS. CINDY D CLOYD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 870-733-9950
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------