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General NPI Number Information
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NPI Number | 1548075310
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Entity Type | Organization
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Legal Business Name | LULA MAE'S DAY CENTER
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 613 W 8TH AVE
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City | PINE BLUFF
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State | AR
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Zip | 71601-4855
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Country | US
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Telephone | 870-663-0472
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 STARLITE DR
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City | PINE BLUFF
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State | AR
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Zip | 71603-3563
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Country | US
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Telephone | 870-550-2984
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. SHANEKA HAMILTON
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Credential | MASTER SOCIAL WORKER
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Telephone | 870-663-0472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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