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General NPI Number Information
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NPI Number | 1861615429
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Entity Type | Organization
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Legal Business Name | ASHLEY COUNTY SKILLED WORKCENTER, INC.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 12/10/2020
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Provider Practice Location Address
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Address Line | 208 N ARKANSAS ST
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City | CROSSETT
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State | AR
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Zip | 71635-2836
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Country | US
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Telephone | 870-364-9253
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Fax | 870-364-9243
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Provider Business Mailing Address
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Address Line | PO BOX 900
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City | CROSSETT
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State | AR
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Zip | 71635-0900
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Country | US
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Telephone | 870-364-9253
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Fax | 870-364-9243
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SHANNON RODRIGUEZ
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Credential |
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Telephone | 870-364-9253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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