Organization
MIRACLE KIDS SUCCESS ACADEMY NORTH
Active
Organization
MIRACLE KIDS SUCCESS ACADEMY NORTH
Active
Parent organization
MIRACLE KIDS SUCCESS ACADEMY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIRACLE KIDS SUCCESS ACADEMY
Authorized official
SHELLY KELLER (CEO/OWNER)
(870) 761-6680
Entity
Organization
Contact information
Practice address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 932-3600
Mailing address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 932-3600
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/31/2018
Last updated
12/31/2018
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