Provider Demographics
NPI:1114050036
Name:CHICOT COUNTY EARLY CHILDHOOD CENTER
Entity Type:Organization
Organization Name:CHICOT COUNTY EARLY CHILDHOOD CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SYKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-265-4191
Mailing Address - Street 1:PO BOX 801
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-0801
Mailing Address - Country:US
Mailing Address - Phone:870-265-4191
Mailing Address - Fax:870-265-4192
Practice Address - Street 1:422 ANNEX ST
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653-1809
Practice Address - Country:US
Practice Address - Phone:870-265-4191
Practice Address - Fax:870-265-4192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR11418251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services