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Organization

KIDSPIRATION BEHAVIORAL HEALTH

Active
Parent organization
KIDSPIRATION OUTPATIENT THERAPY SERVICES
Other names
Kidspiration Behavioral Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
KIDSPIRATION OUTPATIENT THERAPY SERVICES
Authorized official
JOLENE SHOCKEY (BILLING MANAGER)
(870) 424-4021
Entity
Organization

Contact information

Practice address
1310 BRADLEY DR, MOUNTAIN HOME, AR 72653-2730
(870) 424-4021
(870) 424-4112
Mailing address
PO BOX 2533, MOUNTAIN HOME, AR 72654-2533
(870) 424-4021
(870) 424-4112

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary

Other

Enumeration date
12/06/2019
Last updated
12/06/2019
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