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General NPI Number Information
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NPI Number | 1346758844
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Entity Type | Organization
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Legal Business Name | LITTLE HAVEN PPECC LLC
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/18/2018
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Provider Practice Location Address
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Address Line | 328 LORENALY DR SUITE 100
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City | BROWNSVILLE
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State | TX
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Zip | 78526
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Country | US
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Telephone | 956-455-5849
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Fax |
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Provider Business Mailing Address
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Address Line | 5453 RUSTIC MANOR DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-3920
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Country | US
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Telephone | 956-455-5849
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHUBHRA SHARMA
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Credential |
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Telephone | 956-455-5849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM3000X
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Taxonomy Name | Medically Fragile Infants and Children Day Care
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License Number |
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License Number State |
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