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General NPI Number Information
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NPI Number | 1861930802
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Entity Type | Organization
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Legal Business Name | RICO'S DAYCARE
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 02/10/2017
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Provider Practice Location Address
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Address Line | 809 BERWICK DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-0837
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Country | US
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Telephone | 910-978-0663
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Fax |
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Provider Business Mailing Address
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Address Line | 809 BERWICK DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28314-0837
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Country | US
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Telephone | 910-978-0663
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | NANCY HERNANDEZ HARVEY
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Credential |
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Telephone | 910-978-0663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 260000648
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License Number State | NC
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