Organization
THE RAY DAE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JANE COOK MS, SDP, CHC (OWNER)
(479) 715-3875
Entity
Organization
Contact information
Practice address
701 MADISON DR, PRAIRIE GROVE, AR 72753-2871
(479) 715-3875
Mailing address
701 MADISON DR, PRAIRIE GROVE, AR 72753-2871
(479) 715-3875
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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