Organization
MIRACLE KIDS SUCCESS ACADEMY NORTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY KELLER (CEO/OWNER)
(870) 761-6680
Entity
Organization
Contact information
Practice address
806 GLENDALE ST, JONESBORO, AR 72401-4455
(870) 333-2600
Mailing address
1900 STILLWATER DR, JONESBORO, AR 72404-9119
(870) 333-2600
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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