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NPI Code Detail

MEDICARE: ARKANSAS EASTER SEAL SOCIETY

MEDICARE: ARKANSAS EASTER SEAL SOCIETY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number : 1881729515
Entity Type Code : Organization
Provider Name (Legal Business Name) : ARKANSAS EASTER SEAL SOCIETY
Provider Business Mailing Address
First Line : 3920 WOODLAND HEIGHTS RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72212-2495
Country : US
Telephone Number : 501-227-3662
Fax Number : 501-227-3658
Provider Business Practice Location Address
First Line : 3920 WOODLAND HEIGHTS RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72212-2495
Country : US
Telephone Number : 501-227-3662
Fax Number : 501-227-3658
Authorized Official
Title or Position : VICE PRESIDENT ADMIN & FINANCE
Name : MS. STEPHANIE GAYLE SMITH
Credential :
Telephone Number : 501-227-3662
Provider Enumeration Date : 02/22/2007
Last Update Date : 08/22/2020

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Directions to “ARKANSAS EASTER SEAL SOCIETY ” Practice Location

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