Organization
CBK KIDS R KIDS
Active
Organization
CBK KIDS R KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORBY GENE GREGORY (EXECUTIVE DIRECTOR)
(870) 222-4544
Entity
Organization
Contact information
Practice address
1014 N MAIN ST, EUDORA, AR 71640-2251
(870) 355-0140
Mailing address
PO BOX 1051, MC GEHEE, AR 71654-1051
(870) 222-4544
(870) 222-4557
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
26748
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191864724
—
AR
Enumeration date
06/19/2012
Last updated
06/19/2012
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