Provider Demographics
NPI:1891919189
Name:JODIE PARTRIDGE CENTER
Entity Type:Organization
Organization Name:JODIE PARTRIDGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTYE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-382-4374
Mailing Address - Street 1:PO BOX 643
Mailing Address - Street 2:
Mailing Address - City:DUMAS
Mailing Address - State:AR
Mailing Address - Zip Code:71639-0643
Mailing Address - Country:US
Mailing Address - Phone:870-382-4374
Mailing Address - Fax:870-382-6814
Practice Address - Street 1:1180 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:DUMAS
Practice Address - State:AR
Practice Address - Zip Code:71639
Practice Address - Country:US
Practice Address - Phone:870-382-4374
Practice Address - Fax:870-382-6814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services