Provider Demographics
NPI:1255455010
Name:SEVIER COUNTY DEVELOPMENTAL CENTER, INC.
Entity type:Organization
Organization Name:SEVIER COUNTY DEVELOPMENTAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-584-3416
Mailing Address - Street 1:PO BOX 348
Mailing Address - Street 2:
Mailing Address - City:DE QUEEN
Mailing Address - State:AR
Mailing Address - Zip Code:71832-0348
Mailing Address - Country:US
Mailing Address - Phone:870-584-3416
Mailing Address - Fax:870-642-8384
Practice Address - Street 1:161 HIGHWAY 399
Practice Address - Street 2:
Practice Address - City:DE QUEEN
Practice Address - State:AR
Practice Address - Zip Code:71832-0161
Practice Address - Country:US
Practice Address - Phone:870-584-3416
Practice Address - Fax:870-642-8384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARCERTIFICATE251C00000X, 251B00000X
261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251B00000XAgenciesCase Management
Not Answered261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities