Organization
MIRACLE KIDS SUCCESS ACADEMY NORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY A KELLER (CEO)
(870) 336-8100
Entity
Organization
Contact information
Practice address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 333-2600
Mailing address
3127 SOUTHWEST DR STE A, JONESBORO, AR 72404-8404
(870) 336-8100
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
11/25/2020
Last updated
12/18/2020
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