Organization
ABC CHILDREN'S ACADEMY
Active
Other names
Recovery Zone Pediatric Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA WARREN PT (OWNER)
(479) 477-0385
Entity
Organization
Contact information
Practice address
500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
(479) 968-5048
(479) 968-1498
Mailing address
500 E 3RD ST, RUSSELLVILLE, AR 72801-5204
(479) 968-5048
(479) 968-1498
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
AR
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176325778
—
AR
05
—
197932724
—
AR
05
—
197933724
—
AR
01
—
5F626
BCBS
AR
Enumeration date
03/06/2007
Last updated
10/11/2021
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