Organization
KIDSPIRATION OUTPATIENT THERAPY SERVICES
Active
Parent organization
KIDSPIRATION OUTPATIENT THERAPY SERVICES
Other names
Kidspiration Waiver Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIDSPIRATION OUTPATIENT THERAPY SERVICES
Authorized official
JOLENE SHOCKEY CPC, CPB (BILLING MANAGER)
(870) 405-8827
Entity
Organization
Contact information
Practice address
1310 BRADLEY DR, MOUNTAIN HOME, AR 72653-2730
(870) 424-4021
(870) 424-4112
Mailing address
1310 BRADLEY DR, MOUNTAIN HOME, AR 72653-2730
(870) 424-4021
(870) 424-4112
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/18/2025
Last updated
09/18/2025
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