Miracle Kids Success Academy of Trumann

NPI #1639773054 in Trumann, Arkansas

Provider Information

NPI Number: 1639773054
Entity Type: Organization
Organization Name: Miracle Kids Success Academy of Trumann
Primary Specialty: Clinic/Center - Developmental Disabilities
Enumeration Date: Nov 25, 2020
Last Updated: Dec 18, 2020

Practice Location

Address: 1005 BALCOM LN
City: Trumann
State: Arkansas
ZIP Code: 72472-9502
Phone: (870) 418-1000

Authorized Official

Name: SHELLY A KELLER
Title: CEO
Phone: (870) 336-8100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation — Rehabilitation	261QR0400X
Clinic/Center - Developmental Disabilities — Developmental Disabilities	261QD1600X	Primary

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