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Organization

STATE OF ARKANSAS

Active
Other names
Booneville Human Development Center
Organization subpart
No

Provider details

NPI number
Authorized official
JUDY L. STOREY (DIRECTOR OF OPERATIONS)
(479) 675-1411
Entity
Organization

Contact information

Practice address
87 REED RD, HIGHWAY 116 SOUTH, BOONEVILLE, AR 72927
(479) 675-2121
(479) 675-5820
Mailing address
87 REED RD, HIGHWAY 116 SOUTH, BOONEVILLE, AR 72927
(479) 675-2121
(479) 675-5820

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
109051213
AR
Enumeration date
03/09/2007
Last updated
06/25/2008
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