Healthcare Provider Details

I. General information

NPI: 1316417751
Provider Name (Legal Business Name): MERRITT VENTURES, LLC, DBA: LICE CLINICS OF AMERICA - LITTLE ROCK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2018
Last Update Date: 11/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N 2ND ST STE D
CABOT AR
72023-2751
US

IV. Provider business mailing address

1011 N 2ND ST STE D
CABOT AR
72023-2751
US

V. Phone/Fax

Practice location:
  • Phone: 501-424-9396
  • Fax:
Mailing address:
  • Phone: 501-424-9396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMBERLY HAYES
Title or Position: CLINIC MANAGER
Credential:
Phone: 501-424-9396