NPI 1467862821

Advantage Program

Organisation Voluntary or Charitable Agency Jonesboro, AR

Practice location

Address: 3529 E Nettleton Ave STE I, Jonesboro, AR 72401-5590
Phone: (870) 336-3360
Fax: (870) 336-3878
Mailing address: 3529 E Nettleton Ave STE I, Jonesboro, AR 72401-5500

Authorised official

Name: Terrell Jenkins
Title: President
Phone: (870) 919-0285

Registered specialties

Voluntary or Charitable Agency Primary

Agencies Taxonomy 251V00000X Licence 1532 (AR)

Other Voluntary or Charitable providers in Arkansas →

Registry record

NPI: 1467862821
Entity type: Organization
NPI issued: 6 May 2014
Record last updated: 6 May 2014

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.