Organization
BLACSHEEP FAMILY AND AUTISM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DE'DRA N THOMPSON (DIRECTOR)
(501) 471-8566
Entity
Organization
Contact information
Practice address
6104 GREENVILLE AVE., NORTH LITTLE ROCK, AR 72118-7211
(501) 471-8580
Mailing address
6834 CANTRELL RD, LITTLE ROCK, AR 72207-4135
(501) 471-8580
Taxonomy
Speciality
Code
Description
License number
State
101200000X
Drama Therapist
—
—
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
221700000X
Art Therapist
—
—
225800000X
Recreation Therapist
Primary
—
—
251300000X
Local Education Agency (LEA)
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
—
332BC3200X
Customized Equipment (DME)
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295491706
—
AR
Enumeration date
11/17/2022
Last updated
01/28/2023
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