Provider Demographics
NPI:1841324209
Name:MCBRYDE THERAPY OPS, INC.
Entity type:Organization
Organization Name:MCBRYDE THERAPY OPS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCBRYDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-994-7778
Mailing Address - Street 1:75 HIGHWAY 62 412
Mailing Address - Street 2:SUITE A
Mailing Address - City:ASH FLAT
Mailing Address - State:AR
Mailing Address - Zip Code:72513-9594
Mailing Address - Country:US
Mailing Address - Phone:870-994-7778
Mailing Address - Fax:870-994-2531
Practice Address - Street 1:75 HIGHWAY 62 412
Practice Address - Street 2:SUITE A
Practice Address - City:ASH FLAT
Practice Address - State:AR
Practice Address - Zip Code:72513-9594
Practice Address - Country:US
Practice Address - Phone:870-994-7778
Practice Address - Fax:870-994-2531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR157448742Medicaid
AR157448742Medicaid