STATE OF ARKANSAS NPI 1801928627

NPI Information

STATE OF ARKANSAS is an intermediate care facility mentally retarded in Booneville, AR. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. STATE OF ARKANSAS NPI is 1801928627. The provider is registered as an organization entity type.
The provider Is Doing Business As Booneville Human Development Center.

The provider's business location address is:

87 REED RD
HIGHWAY 116 SOUTH
BOONEVILLE, AR
ZIP 72927
Phone: (479) 675-2121
Fax: (479) 675-5820

The provider's authorized official is Judy L. Storey .
The authorized official title is Director Of Operations and has the following contact phone number (479) 675-1411.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 6/25/2008.

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:

Other Identifiers

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

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