Siloam Springs Adult Development Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

251C00000X Issued in AR

Legal business name

SILOAM SPRINGS ADULT DEVELOPMENT INC

Practice address

500 N Country Club Rd
Siloam Springs, AR 72761-2920

Phone

(479) 524-5911

Fax

(479) 524-8075

NPI assigned

Apr 15, 2008

Organization subpart

No

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

Authorized official

Name

Bradley G Dezurik

Title

Administrator

Phone

(479) 524-5911

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1992979504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 585",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727610585",
            "telephone_number": "479-524-5911",
            "fax_number": "479-524-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N COUNTRY CLUB RD",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727612920",
            "telephone_number": "479-524-5911",
            "fax_number": "479-524-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILOAM SPRINGS ADULT DEVELOPMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "DEZURIK",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "479-524-5911"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "AR",
            "license": "251C00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brock Shinkle, LAC
• Linda Shipp, APRN
• Siloam Emergency Group LLC
• Siloam Eye Care
• Siloam Healthcare LLC
• Siloam Springs Arkansas Hospital Company LLC
• Siloam Springs Arkansas Hospital Company LLC
• Siloam Springs Clinic Company LLC
• Siloam Springs Clinic Company, LLC
• Siloam Springs Dental Care PLLC

• Developmentally Disabled Services Day Training Agency in Siloam Springs, AR
• Providers in Siloam Springs, AR by specialty
• Developmentally Disabled Services Day Training Agency in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.