STATE PF ARKANSAS NPI 1386770030

NPI Information

  • NPI: 1386770030
  • Provider Name: STATE PF ARKANSAS
  • Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
  • Entity Type: Organization
  • Doing Business As: JONESBORO HUMAN DEVELOPMENT CENTER
  • Address: 4701 COLONY DR
    JONESBORO, AR
    ZIP 72404
  • Phone: (870) 932-4043

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NPI Details

STATE PF ARKANSAS is a residential treatment facility, intellectual and/or developmental disabilities in Jonesboro, AR. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. STATE PF ARKANSAS NPI is 1386770030. The provider is registered as an organization entity type.
The provider Is Doing Business As Jonesboro Human Development Center.

The provider's business location address is:

4701 COLONY DR
JONESBORO, AR
ZIP 72404-317
Phone: (870) 932-4043
Fax: (870) 932-4459

The provider's authorized official is Theresia Diane Keith .
The authorized official title is Superintendent and has the following contact phone number (870) 932-4043.

The enumeration date for this NPI number is 2/26/2007 and was last updated on 8/16/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities137ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1109054213MEDICAIDARKANSAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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