Provider Demographics
NPI:1386964351
Name:KIDS FOR THE FUTURE OF HELENA, INC
Entity type:Organization
Organization Name:KIDS FOR THE FUTURE OF HELENA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:HEISLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:870-633-1737
Mailing Address - Street 1:515 MCDONOUGH
Mailing Address - Street 2:PO BOX 364
Mailing Address - City:HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72342-2912
Mailing Address - Country:US
Mailing Address - Phone:870-338-8106
Mailing Address - Fax:870-338-3480
Practice Address - Street 1:515 MCDONOUGH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-2912
Practice Address - Country:US
Practice Address - Phone:870-338-8106
Practice Address - Fax:870-338-3480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-01
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1665101YP2500X, 133N00000X, 224Z00000X, 163W00000X, 2251P0200X, 225200000X, 225X00000X, 235Z00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR181132724Medicaid