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General NPI Number Information
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NPI Number | 1538339106
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Entity Type | Organization
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Legal Business Name | KID KARE INC
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 03/14/2008
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Provider Practice Location Address
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Address Line | 4736 JACKSON ST
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2505
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Country | US
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Telephone | 318-613-0195
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Fax | 318-449-3737
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Provider Business Mailing Address
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Address Line | PO BOX 13252
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City | ALEXANDRIA
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State | LA
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Zip | 71315-3252
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Country | US
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Telephone | 318-613-0195
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Fax | 318-449-3737
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Authorized Official
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Title or Position | OWNER
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Name | WANEL N YOUNGBLOOD
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Credential |
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Telephone | 318-613-0195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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