Miracle Kids Success Academy, Inc.
LBN: Miracle Kids Success Academy, Inc.
Miracle Kids Success Academy, Inc. is an health care organization with primary practice located at 1900 Stillwater Dr , Jonesboro AR 72404-9119. The organization recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Developmental Disabilities, Ambulatory Health Care Facilities / Adolescent and Children Mental Health, Ambulatory Health Care Facilities / Rehabilitation. Ambulatory Health Care Facilities / Rehabilitation is the primary health care specialty.
Miracle Kids Success Academy, Inc. can be contacted via phone (870) 932-3600, or through Keller, Shelly via phone (870) 932-3600.
Contact Information
Primary practice address
1900 Stillwater Dr
Jonesboro AR 72404-9119
Phone: (870) 932-3600
Fax: (870) 932-3611
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Developmental Disabilities | 261QD1600X | ||
| Ambulatory Health Care Facilities / Adolescent and Children Mental Health | 261QM0855X | ||
| Ambulatory Health Care Facilities / Rehabilitation | 261QR0400X |
Profile Details
| NPI number | 1568799658 |
|---|---|
| LBN Legal business name | Miracle Kids Success Academy, Inc. |
| DBA Doing business as | |
| Authorized official | Keller, Shelly MCD, CCC-SLP |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 10th, 2009 |
| Last updated | Nov 30th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568799658 | NPPES |
| Arkansas | MEDICAID | 179889724 |
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