Provider Demographics
NPI:1952565590
Name:OUACHITA CHILDRENS CENTER INC
Entity Type:Organization
Organization Name:OUACHITA CHILDRENS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-623-5591
Mailing Address - Street 1:PO BOX 1180
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71902-1180
Mailing Address - Country:US
Mailing Address - Phone:501-623-5591
Mailing Address - Fax:501-623-4226
Practice Address - Street 1:339 CHARTEROAK ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6100
Practice Address - Country:US
Practice Address - Phone:501-623-5591
Practice Address - Fax:501-623-4226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10067385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR135934789Medicaid