Provider Demographics
NPI:1376671008
Name:THE LEARNING CENTER OF NORTHEAST ARKANSAS, INC.
Entity Type:Organization
Organization Name:THE LEARNING CENTER OF NORTHEAST ARKANSAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-335-2240
Mailing Address - Street 1:2808 FOX MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-9346
Mailing Address - Country:US
Mailing Address - Phone:870-932-4245
Mailing Address - Fax:870-931-4457
Practice Address - Street 1:2808 FOX MEADOW LN
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9346
Practice Address - Country:US
Practice Address - Phone:870-932-4245
Practice Address - Fax:870-931-4457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR117641724Medicaid
AR117538742Medicaid
AR5C636OtherAR BCBS PROVIDER #
AR145862778Medicaid
AR132566786OtherDDTCS, 03, 14, 06
AR118326715Medicaid