Provider Demographics
NPI:1437462900
Name:ECONOMIC OPPORTUNITY OF WASHINGTON COUNTY, INC
Entity Type:Organization
Organization Name:ECONOMIC OPPORTUNITY OF WASHINGTON COUNTY, INC
Other - Org Name:EOA OF WASHINGTON COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-872-7479
Mailing Address - Street 1:614 E EMMA AVE STE M401
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-4634
Mailing Address - Country:US
Mailing Address - Phone:479-872-7479
Mailing Address - Fax:479-872-7482
Practice Address - Street 1:614 E EMMA AVE STE M401
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-4634
Practice Address - Country:US
Practice Address - Phone:479-872-7479
Practice Address - Fax:479-872-7482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable