Provider Demographics
NPI:1831670876
Name:SKYROCIT, INC.
Entity type:Organization
Organization Name:SKYROCIT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-722-1200
Mailing Address - Street 1:PO BOX 1540
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71802-1540
Mailing Address - Country:US
Mailing Address - Phone:870-777-4501
Mailing Address - Fax:870-777-8618
Practice Address - Street 1:500 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-5206
Practice Address - Country:US
Practice Address - Phone:870-777-4501
Practice Address - Fax:870-777-8618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-28
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR220921773Medicaid
AR220922772Medicaid
AR220931774Medicaid
AR220920782Medicaid
AR220490767Medicaid