| Blacsheep Family And Autism | |
|
6104 Greenville Ave. North Little Rock AR 72118-7211 | |
| (501) 471-8580 | |
| Not Available |
| Full Name | Blacsheep Family And Autism |
|---|---|
| Speciality | Recreation Therapist |
| Location | 6104 Greenville Ave., North Little Rock, Arkansas |
| Authorized Official Name and Position | De'dra N Thompson (DIRECTOR) |
| Authorized Official Contact | 5014718566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blacsheep Family And Autism 6834 Cantrell Rd Little Rock AR 72207-4135 Ph: (501) 471-8580 | Blacsheep Family And Autism 6104 Greenville Ave. North Little Rock AR 72118-7211 Ph: (501) 471-8580 |
| NPI Number | 1710696893 |
|---|---|
| Provider Enumeration Date | 11/17/2022 |
| Last Update Date | 01/28/2023 |
| Certification Date | 01/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710696893 | NPI | - | NPPES |
| 295491706 | Medicaid | AR |
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