Provider Demographics
NPI:1265575237
Name:ALL GOD'S CHILDREN THERAPY CENTER
Entity type:Organization
Organization Name:ALL GOD'S CHILDREN THERAPY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, OCCUPATIONAL THERAPIEST
Authorized Official - Prefix:MRS
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:501-513-9555
Mailing Address - Street 1:1106 DEER ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5414
Mailing Address - Country:US
Mailing Address - Phone:501-513-9555
Mailing Address - Fax:501-664-2354
Practice Address - Street 1:1200 N JAMES ST STE A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-3167
Practice Address - Country:US
Practice Address - Phone:501-513-9555
Practice Address - Fax:501-664-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty