Organization
MARVA WORKSHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESA LYNN PARKER (EXECUTIVE DIRECTOR)
(479) 968-4420
Entity
Organization
Contact information
Practice address
1205 S ARKANSAS AVE, RUSSELLVILLE, AR 72801-6736
(479) 968-4420
(479) 968-5430
Mailing address
1205 S ARKANSAS AVE, RUSSELLVILLE, AR 72801-6736
(479) 968-4420
(479) 968-5430
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2380
STATE DDS PROVIDER CODE
AR
Enumeration date
01/09/2007
Last updated
08/22/2020
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