Provider Demographics
NPI:1588802060
Name:NORTHWEST AR ESC
Entity Type:Organization
Organization Name:NORTHWEST AR ESC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EARLY CHILDHOOD COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-267-5960
Mailing Address - Street 1:4 N DOUBLE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:AR
Mailing Address - Zip Code:72730-2522
Mailing Address - Country:US
Mailing Address - Phone:479-267-5960
Mailing Address - Fax:
Practice Address - Street 1:4 N DOUBLE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730-2522
Practice Address - Country:US
Practice Address - Phone:479-267-5960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)