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Organization
KIDSCHOICE THERAPEUTIC SERVICES
Active
Organization
KIDSCHOICE THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESSIE LUVENIA HEWETT (DIRECTOR)
(501) 343-9508
Entity
Organization
Contact information
Practice address
32 BROADMOOR DR, LITTLE ROCK, AR 72204-4821
(501) 343-9508
(501) 537-8084
Mailing address
32 BROADMOOR DR, PO BOX 4582, LITTLE ROCK, AR 72204-4821
(501) 343-9508
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
SCIN22A
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132743785
—
AR
05
—
164949778
—
AR
05
—
164950724
—
AR
05
—
165045742
—
AR
Enumeration date
05/23/2008
Last updated
05/23/2008
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