Provider Demographics
NPI:1346365707
Name:MISS POLLY'S DAY CARE CENTER
Entity Type:Organization
Organization Name:MISS POLLY'S DAY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSE
Authorized Official - Phone:870-238-2368
Mailing Address - Street 1:613 CHURCH ST N
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-2603
Mailing Address - Country:US
Mailing Address - Phone:870-238-2368
Mailing Address - Fax:870-238-7889
Practice Address - Street 1:613 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-2603
Practice Address - Country:US
Practice Address - Phone:870-238-2368
Practice Address - Fax:870-238-7889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services