| NPI | 1467883181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM LEE CLARK Owner 318-213-1281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM3000X Clinic/Center, Medically Fragile Infants and Children Day Care |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2017-03-02 |