Organization
OUR MOMMY'S AND DADDDY'S ADULT DAY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MAXCINE HENDERSON CNA (DIRECTOR)
(870) 692-5879
Entity
Organization
Contact information
Practice address
1406 E HARDING AVE, PINE BLUFF, AR 71601-6168
(870) 536-7404
Mailing address
1406 E HARDING AVE, PINE BLUFF, AR 71601-6168
(870) 536-7404
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
146
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188575755
—
AR
Enumeration date
10/27/2011
Last updated
10/27/2011
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