# STATE PF ARKANSAS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Jonesboro Human Development Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386770030
- **Authorized official:** MRS. THERESIA DIANE KEITH (SUPERINTENDENT)
- **Authorized official phone:** (870) 932-4043

## Contact information

- **Practice address:** 4701 COLONY DR, JONESBORO, AR 72404-9317
- **Practice address phone:** (870) 932-4043
- **Practice address fax:** (870) 932-4459
- **Mailing address:** 4701 COLONY DR, JONESBORO, AR 72404-9317
- **Mailing address phone:** (870) 932-4043
- **Mailing address fax:** (870) 932-4459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 137 | AR | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 08/16/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 109054213 | — | AR |