| Miracle Kids Success Academy Central | |
|
1607 Stone St Jonesboro AR 72401-5332 | |
| (870) 336-4100 | |
| Not Available |
| Full Name | Miracle Kids Success Academy Central |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 1607 Stone St, Jonesboro, Arkansas |
| Authorized Official Name and Position | Jeremy Edward Ellis (CONTROLLER) |
| Authorized Official Contact | 8703364100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Kids Success Academy Central 1607 Stone St Jonesboro AR 72401-5332 Ph: (870) 336-4100 | Miracle Kids Success Academy Central 1607 Stone St Jonesboro AR 72401-5332 Ph: (870) 336-4100 |
| NPI Number | 1346168333 |
|---|---|
| Provider Enumeration Date | 07/07/2026 |
| Last Update Date | 07/07/2026 |
| Certification Date | 07/07/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346168333 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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