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Contact Information

MIRACLE KIDS SUCCESS ACADEMY NORTH
806 GLENDALE ST
JONESBORO, AR72401-4455
 Phone: 870-333-2600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental Disabilities

261QD1600X
 

Rehabilitation

261QR0400X B4[14] Rehabilitation Agency
Indicates primary specialty

NPI Profile & details for MIRACLE KIDS SUCCESS ACADEMY NORTH

NPI Number 1255935680
LBN Legal business name MIRACLE KIDS SUCCESS ACADEMY NORTH
Authorized official SHELLY KELLER - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/25/2020
Last updated 12/18/2020 - About 5 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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