Kids Unlimited of Washington County Inc

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

KIDS UNLIMITED OF WASHINGTON COUNTY INC

Practice address

120 Southwinds Rd Ste 2
Farmington, AR 72730-8652

Phone

(479) 300-6400

NPI assigned

Dec 18, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shelly A. Keller

Title

Ceo

Phone

(870) 336-8100

Specialties & licenses 1

Addresses

Tax ID family

Kids Unlimited of Washington County Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Kids Unlimited of Washington County Inc

  • Rehabilitation Clinic/Center
  • Farmington, AR
  • NPI 1477971075
  NPD tax ID
• Kids Unlimited of Washington Coutny, Inc.

  • Occupational Therapist
  • Farmington, AR
  • NPI 1871932319
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1104412568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3127 SOUTHWEST DR STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724048404",
            "telephone_number": "870-336-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SOUTHWINDS RD STE 2",
            "city": "FARMINGTON",
            "state": "AR",
            "postal_code": "727308652",
            "telephone_number": "479-300-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS UNLIMITED OF WASHINGTON COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-336-8100"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latisha Johnson, LPC
• Trent Johnson
• Kaleidoscope Center for Healing Arts
• Liza Garcia Kearney, RPT
• Martin Keith
• Kids Unlimited of Washington County Inc
• Kids Unlimited of Washington Coutny, Inc.
• Kateri Barbara Killman, LCSW
• Jessica King, R.N.
• Karen Joelle Kobliska, PSYD

• Developmental Disabilities Clinic/Center in Farmington, AR
• Providers in Farmington, AR by specialty
• Developmental Disabilities Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.