# KIDS UNLIMITED LEARNING ACADEMY OF FAYETTEVILLE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MIRACLE KIDS SUCCESS ACADEMY, INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1629851191
- **Legal business name:** MIRACLE KIDS SUCCESS ACADEMY, INC.
- **Authorized official:** SHELLY KELLER MCD, CCC-SLP (CEO)
- **Authorized official phone:** (870) 336-8100

## Contact information

- **Practice address:** 1760 N WOODLAND AVE, FAYETTEVILLE, AR 72703-2549
- **Practice address phone:** (479) 443-4420
- **Mailing address:** 3127 SOUTHWEST DR STE A, JONESBORO, AR 72404-8404
- **Mailing address phone:** (870) 336-8100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/17/2023
- **Last updated:** 08/17/2023