Provider Demographics
NPI:1558910224
Name:KATHERINE'S LITTLE ANGELS ADULT CARE CENTER
Entity Type:Organization
Organization Name:KATHERINE'S LITTLE ANGELS ADULT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHAUN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MCFADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-850-7797
Mailing Address - Street 1:2006 W 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-5182
Mailing Address - Country:US
Mailing Address - Phone:870-850-7797
Mailing Address - Fax:870-850-7797
Practice Address - Street 1:2006 W 27TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-5182
Practice Address - Country:US
Practice Address - Phone:870-850-7797
Practice Address - Fax:870-850-7797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care