| NPI | 1043530017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS R HEISLER CEO 870-633-1737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: AR 26859) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: AR 26859) |
| 133N00000X Nutritionist (Licence: AR 26859) | |
| 163W00000X Registered Nurse (Licence: AR 26859) | |
| 224Z00000X Occupational Therapy Assistant (Licence: AR 26859) | |
| 225100000X Physical Therapist (Licence: AR 26859) | |
| 225200000X Physical Therapy Assistant (Licence: AR 26859) | |
| 225X00000X Occupational Therapist (Licence: AR 26859) | |
| 235Z00000X Speech-Language Pathologist (Licence: AR 26859) | |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2010-06-02 |