Organization Name: | PHILLIPS COUNTY DEVELOPMENTAL CENTER |
NPI Number: | 1508079831 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HENRIETTA WILSON (DIRECTOR) |
Mailing Address: | 1221 W Highway 49 West Helena |
State: | AR US |
Postal Code: | 723901716 |
Phone Number: | 8705723417 |
Fax Number: | 8705722653 |
NPI Enumeration Date: | 05/07/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA0600X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Day Care |
Taxonomy Definition: |