Provider Demographics
NPI:1467883181
Name:CARING HANDS PEDIATRIC DAY HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:CARING HANDS PEDIATRIC DAY HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-213-1281
Mailing Address - Street 1:1009 PROFESSIONAL DR W
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5624
Mailing Address - Country:US
Mailing Address - Phone:318-213-1281
Mailing Address - Fax:318-213-1282
Practice Address - Street 1:1009 PROFESSIONAL DR W
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5624
Practice Address - Country:US
Practice Address - Phone:318-213-1281
Practice Address - Fax:318-213-1282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-05
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care