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General NPI Number Information
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NPI Number | 1891919189
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Entity Type | Organization
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Legal Business Name | JODIE PARTRIDGE CENTER
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1180 HIGHWAY 165
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City | DUMAS
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State | AR
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Zip | 71639
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Country | US
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Telephone | 870-382-4374
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Fax | 870-382-6814
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Provider Business Mailing Address
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Address Line | PO BOX 643
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City | DUMAS
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State | AR
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Zip | 71639-0643
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Country | US
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Telephone | 870-382-4374
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Fax | 870-382-6814
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. BETTYE RUTH HARRIS
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Credential |
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Telephone | 870-382-4374
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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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