State of Arkansas
NPI #1801928627 in Booneville, Arkansas
Provider Information
- NPI Number
- 1801928627
- Entity Type
- Organization
- Organization Name
- State of Arkansas
- Primary Specialty
- Intermediate Care Facility, Intellectual Disabilities
- Enumeration Date
- Mar 9, 2007
- Last Updated
- Jun 25, 2008
Practice Location
- Address
- 87 REED RD
- Address 2
- HIGHWAY 116 SOUTH
- City
- Booneville
- State
- Arkansas
- ZIP Code
- 72927
- Phone
- (479) 675-2121
Authorized Official
- Name
- JUDY L. STOREY
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (479) 675-1411
Specialties & Taxonomy Codes
| Specialty |
|---|
| Intermediate Care Facility, Intellectual Disabilities |
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