MEDICARE: OUACHITA ENRICHMENT CENTERS, INC.

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
1	251C00000X	Developmentally Disabled Services Day Training Agency		AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962407759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OUACHITA ENRICHMENT CENTERS, INC.

Provider Business Mailing Address
First Line	:	206 W WASHINGTON ST
Second Line	:
City	:	CAMDEN
State	:	AR
Zip	:	71701-3958
Country	:	US
Telephone Number	:	870-836-3056
Fax Number	:	870-498-8838

Provider Business Practice Location Address
First Line	:	206 W WASHINGTON ST
Second Line	:
City	:	CAMDEN
State	:	AR
Zip	:	71701-3958
Country	:	US
Telephone Number	:	870-836-3056
Fax Number	:	870-498-8838

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MISS CRYSTAL CHANDLER
Credential	:
Telephone Number	:	870-836-3056

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	06/03/2024

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