Provider Demographics
NPI:1821144296
Name:LOGAN COUNTY DAY SERVICE CENTER FOR LIMITED CHILDREN INC
Entity Type:Organization
Organization Name:LOGAN COUNTY DAY SERVICE CENTER FOR LIMITED CHILDREN INC
Other - Org Name:LCDSC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-675-3770
Mailing Address - Street 1:1234 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOONEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72927-4915
Mailing Address - Country:US
Mailing Address - Phone:479-675-3770
Mailing Address - Fax:479-675-5812
Practice Address - Street 1:1234 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BOONEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72927-4915
Practice Address - Country:US
Practice Address - Phone:479-675-3770
Practice Address - Fax:479-675-5812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services