Provider Demographics
NPI:1053601336
Name:GREAT EXPECTATIONS DEVELOPMENTAL CENTER
Entity type:Organization
Organization Name:GREAT EXPECTATIONS DEVELOPMENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRENCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-569-9092
Mailing Address - Street 1:6323 COLONEL GLENN RD STE 108
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-7757
Mailing Address - Country:US
Mailing Address - Phone:501-569-9092
Mailing Address - Fax:501-569-9018
Practice Address - Street 1:6323 COLONEL GLENN RD STE 108
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-7757
Practice Address - Country:US
Practice Address - Phone:501-569-9092
Practice Address - Fax:501-569-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164136742Medicaid