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General NPI Number Information
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NPI Number | 1558910224
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Entity Type | Organization
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Legal Business Name | KATHERINE'S LITTLE ANGELS ADULT CARE CENTER
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 2006 W 27TH AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-5182
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Country | US
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Telephone | 870-850-7797
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Fax | 870-850-7797
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Provider Business Mailing Address
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Address Line | 2006 W 27TH AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-5182
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Country | US
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Telephone | 870-850-7797
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Fax | 870-850-7797
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. LASHAUN RENEE MCFADDEN
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Credential |
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Telephone | 870-850-7797
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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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