NPI 1386770030

State Pf Arkansas

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Jonesboro, AR

Practice location

Address: 4701 Colony Dr, Jonesboro, AR 72404-9317
Phone: (870) 932-4043
Fax: (870) 932-4459

Authorised official

Name: Theresia Diane Keith
Title: Superintendent
Phone: (870) 932-4043

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X Licence 137 (AR)

Other Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Arkansas →

Registry record

NPI: 1386770030
Entity type: Organization
NPI issued: 26 Feb 2007
Record last updated: 16 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.