Organization
EARTH ANGELS PEDIATRIC DAY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA M KELLY (MANAGING MEMBER)
(954) 234-5589
Entity
Organization
Contact information
Practice address
2045 N HWY 360 STE 100, GRAND PRAIRIE, TX 75050-1432
(954) 234-5589
Mailing address
2700 BRIERFIELD DR, MONROE, LA 71201-3047
(954) 234-5589
Taxonomy
Speciality
Code
Description
License number
State
261QM3000X
Medically Fragile Infants and Children Day Care
Primary
—
—
Other
Enumeration date
06/15/2022
Last updated
06/15/2022
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