Provider Demographics
NPI:1003041526
Name:KIDS FOR THE FUTURE, INC.
Entity Type:Organization
Organization Name:KIDS FOR THE FUTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:HEISLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:870-755-2737
Mailing Address - Street 1:206 LAKE STREET
Mailing Address - Street 2:
Mailing Address - City:PARKIN
Mailing Address - State:AR
Mailing Address - Zip Code:72373-0252
Mailing Address - Country:US
Mailing Address - Phone:870-755-2737
Mailing Address - Fax:870-755-2740
Practice Address - Street 1:206 LAKE STREET
Practice Address - Street 2:
Practice Address - City:PARKIN
Practice Address - State:AR
Practice Address - Zip Code:72373-0252
Practice Address - Country:US
Practice Address - Phone:870-755-2737
Practice Address - Fax:870-755-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR23984103K00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR176147526Medicaid