Organization
C & D DISABILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA ROBERSON (OWNER)
(870) 836-8880
Entity
Organization
Contact information
Practice address
2300 OUACHITA ROAD 4, STEPHENS, AR 71764-9196
(870) 836-8880
Mailing address
2300 OUACHITA ROAD 4, STEPHENS, AR 71764-9196
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
132646786
VOUCHER
AR
05
—
145905778
—
AR
Enumeration date
04/10/2007
Last updated
06/25/2008
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