NPI 1558908780 · live from the CMS NPI Registry
Kidspiration Behavioral Health
Pediatrics, Developmental - Behavioral Pediatrics in Mountain Home, AR. National Provider Identifier 1558908780, active.
NPI record
| NPI | 1558908780 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics, Developmental - Behavioral Pediatrics 2080P0006X |
| Practice location | 1310 Bradley Dr, Mountain Home, AR 72653 |
| Practice phone | 870-424-4021 |
| Mailing address | Po Box 2533, Mountain Home, AR 72654 |
| Enumerated | December 6, 2019 |
| Last updated | December 6, 2019 |
| Authorized official | Jolene Shockey, Billing Manager |
| Other names | Kidspiration Behavioral Health |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics, Developmental - Behavioral Pediatrics primary | 2080P0006X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.