Provider Demographics
NPI:1528150471
Name:DARCYN THERAPY LLC
Entity type:Organization
Organization Name:DARCYN THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUDREAUX
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:501-882-3179
Mailing Address - Street 1:897 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-9798
Mailing Address - Country:US
Mailing Address - Phone:501-882-3179
Mailing Address - Fax:501-882-1036
Practice Address - Street 1:2501 E MOORE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4751
Practice Address - Country:US
Practice Address - Phone:501-288-1199
Practice Address - Fax:501-882-1036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR751225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F347OtherBLUE CROSS BLUE SHIELD
AR5F347Medicare ID - Type UnspecifiedGROUP NUMBER