# MIRACLE KIDS SUCCESS ACADEMY NORTH

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

## Provider details

- **NPI number:** 1912479452
- **Authorized official:** SHELLY KELLER (CEO/OWNER)
- **Authorized official phone:** (870) 761-6680

## Contact information

- **Practice address:** 806 GLENDALE ST, JONESBORO, AR 72401-4455
- **Practice address phone:** (870) 333-2600
- **Mailing address:** 1900 STILLWATER DR, JONESBORO, AR 72404-9119
- **Mailing address phone:** (870) 333-2600

## Taxonomy

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

## Other

- **Enumeration date:** 12/21/2018
- **Last updated:** 12/21/2018