Provider Demographics
NPI:1669853214
Name:BEAN'S TOTS AND TODDLERS LEARNING CENTER
Entity Type:Organization
Organization Name:BEAN'S TOTS AND TODDLERS LEARNING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-933-1989
Mailing Address - Street 1:3401 RACE ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-7419
Mailing Address - Country:US
Mailing Address - Phone:870-933-1989
Mailing Address - Fax:870-268-6705
Practice Address - Street 1:3401 RACE ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7419
Practice Address - Country:US
Practice Address - Phone:870-933-1989
Practice Address - Fax:870-268-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR201133742Medicaid