Organization
MIRACLE KIDS SUCCESS ACADEMY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY-KATHERINE HARDIN MCD, CCC-SLP (OWNER/SECRETARY)
(870) 793-3200
Entity
Organization
Contact information
Practice address
200 GENERAL ST, BATESVILLE, AR 72501-9407
(870) 793-3200
(870) 793-3208
Mailing address
200 GENERAL ST, BATESVILLE, AR 72501-9407
(870) 793-3200
(870) 793-3208
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179780724
—
AR
Enumeration date
01/14/2010
Last updated
01/14/2010
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