# ABC CHILDREN'S ACADEMY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Recovery Zone Pediatric Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417087131
- **Authorized official:** MRS. DANA WARREN PT (OWNER)
- **Authorized official phone:** (479) 477-0385

## Contact information

- **Practice address:** 500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
- **Practice address phone:** (479) 968-5048
- **Practice address fax:** (479) 968-1498
- **Mailing address:** 500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
- **Mailing address phone:** (479) 968-5048
- **Mailing address fax:** (479) 968-1498

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 222Q00000X | Developmental Therapist | — | AR | — |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | Yes |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 10/11/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 176325778 | — | AR |
| 05 | — | 197932724 | — | AR |
| 05 | — | 197933724 | — | AR |
| 01 | — | 5F626 | BCBS | AR |