Provider Demographics
NPI:1134347818
Name:DREW COUNTY DEVELOPMENTAL DISABILITY COUNCIL, INC.
Entity type:Organization
Organization Name:DREW COUNTY DEVELOPMENTAL DISABILITY COUNCIL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-367-6825
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:AR
Mailing Address - Zip Code:71657-0359
Mailing Address - Country:US
Mailing Address - Phone:870-367-6825
Mailing Address - Fax:870-367-0140
Practice Address - Street 1:168 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:AR
Practice Address - Zip Code:71655
Practice Address - Country:US
Practice Address - Phone:870-367-6825
Practice Address - Fax:870-367-0140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251B00000XAgenciesCase Management
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered347B00000XTransportation ServicesBus