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General NPI Number Information
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NPI Number | 1053248872
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Entity Type | Organization
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Legal Business Name | A DIVINE REFRESHING ADULT DAYCARE CENTER
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Dates
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Enumeration Date | 05/06/2026
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 3742 HIGHWAY 1
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City | RACELAND
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State | LA
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Zip | 70394-3141
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Country | US
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Telephone | 985-837-7674
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Fax |
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Provider Business Mailing Address
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Address Line | 1719 HIMALAYA AVE
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City | THIBODAUX
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State | LA
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Zip | 70301-5309
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Country | US
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Telephone | 985-837-7674
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WYDRICKA LOFTON
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Credential |
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Telephone | 985-837-7674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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