# PEDIATRIC SPECIALTY CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831220334
- **Authorized official:** MR. LARRY LAMAR GRANT LPC (MENTAL HEALTH PROFESSIONAL)
- **Authorized official phone:** (870) 245-2210

## Contact information

- **Practice address:** 2410 PINE ST, ARKADELPHIA, AR 71923-4335
- **Practice address phone:** (870) 245-2210
- **Mailing address:** 141 GRISHAM RD, ROYAL, AR 71968-9563
- **Mailing address phone:** (501) 282-2750

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | P0607039 | AR | Yes |

## Other

- **Enumeration date:** 03/08/2007
- **Last updated:** 08/22/2020