TEXARKANA SPECIAL EDUCATION CENTER, INC.

Provider Demographics

• NPI: 1174676415
• Name: TEXARKANA SPECIAL EDUCATION CENTER, INC.
• Entity Type: Organization
• Organization Name: TEXARKANA SPECIAL EDUCATION CENTER, INC.
• Other - Org Name: OPPORTUNITIES, INC.
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: EXECUTIVE DIRECTOR
• Authorized Official - Prefix: MRS
• Authorized Official - First Name: SHERRY
• Authorized Official - Last Name: YOUNG
• Authorized Official - Phone: 903-791-2270
• Mailing Address - Street 1: 6101 N STATE LINE AVE
• Mailing Address - City: TEXARKANA
• Mailing Address - State: TX
• Mailing Address - Zip Code: 75503-5309
• Mailing Address - Country: US
• Mailing Address - Phone: 903-791-2270
• Mailing Address - Fax: 903-792-0816
• Practice Address - Street 1: 6101 N STATE LINE AVE
• Practice Address - City: TEXARKANA
• Practice Address - State: TX
• Practice Address - Zip Code: 75503-5309
• Practice Address - Country: US
• Practice Address - Phone: 903-791-2270
• Practice Address - Fax: 903-792-0816
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-01-19
• Last Update Date: 2024-01-30

Provider Licenses

State	License ID	Taxonomies
AR	DDS COMMUNITY PROGRA	251C00000X, 310400000X
TX	116956	251C00000X
AR	PT1532	261Q00000X
AR	SP#477	261Q00000X
TX	1158790	261Q00000X
TX	100348	261Q00000X
TX	109611	261Q00000X
TX	152450	261Q00000X
TX	116469	261QA0600X
		261QD1600X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	251C00000X	Agencies	Day Training, Developmentally Disabled Services
No	261Q00000X	Ambulatory Health Care Facilities	Clinic/Center
No	261QA0600X	Ambulatory Health Care Facilities	Clinic/Center	Adult Day Care
No	261QD1600X	Ambulatory Health Care Facilities	Clinic/Center	Developmental Disabilities
No	310400000X	Nursing & Custodial Care Facilities	Assisted Living Facility

Provider Identifiers

State	Identifier ID	ID Type	Issuer
AR	103422724	Medicaid
AR	121414732	Medicaid
AR	132790767	Medicaid
TX	1575342-01	Medicaid
TX	1760274-01	Medicaid
TX	001000533	Medicaid
TX	0023GT	Other	PRIVATE INSURANCE BCBS
TX	0174476-01	Medicaid
AR	116391742	Medicaid
AR	135693721	Medicaid
AR	146240778	Medicaid
AR	149109755	Medicaid
TX	0056749-01	Medicaid
AR	116527721	Medicaid
AR	130429774	Medicaid
TX	001004554	Medicaid
AR	119195715	Medicaid
AR	132655786	Medicaid