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Organization

CHILD & YOUTH PEDIATRIC DAY CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMBER HOGARD (DIRECTOR)
(870) 933-9528
Entity
Organization

Contact information

Practice address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 933-9528
Mailing address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 933-9528

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
160740526
AR
05
160751724
AR
05
160767742
AR
Enumeration date
03/11/2010
Last updated
03/11/2010
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