Organization
GREAT RIVER CHILD CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY K TUCKER (OWNER)
(319) 752-0940
Entity
Organization
Contact information
Practice address
639 S CENTRAL AVE, BURLINGTON, IA 52601-3946
(319) 752-0940
(319) 752-0941
Mailing address
639 S CENTRAL AVE, BURLINGTON, IA 52601-3946
(319) 752-0940
(319) 752-0941
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
4129000011
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0418160
—
IA
Enumeration date
06/26/2007
Last updated
08/22/2020
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