# GREAT RIVER CHILD CARE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104022953
- **Authorized official:** NANCY K TUCKER (OWNER)
- **Authorized official phone:** (319) 752-0940

## Contact information

- **Practice address:** 639 S CENTRAL AVE, BURLINGTON, IA 52601-3946
- **Practice address phone:** (319) 752-0940
- **Practice address fax:** (319) 752-0941
- **Mailing address:** 639 S CENTRAL AVE, BURLINGTON, IA 52601-3946
- **Mailing address phone:** (319) 752-0940
- **Mailing address fax:** (319) 752-0941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | 4129000011 | IA | Yes |

## Other

- **Enumeration date:** 06/26/2007
- **Last updated:** 08/22/2020