Provider Demographics
NPI:1205276581
Name:A DIVINE TOUCH II CHILDCARE CENTER,INC
Entity type:Organization
Organization Name:A DIVINE TOUCH II CHILDCARE CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANTOINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-612-4406
Mailing Address - Street 1:213 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-4504
Mailing Address - Country:US
Mailing Address - Phone:501-612-4406
Mailing Address - Fax:501-985-0054
Practice Address - Street 1:213 W MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-4504
Practice Address - Country:US
Practice Address - Phone:501-612-4406
Practice Address - Fax:501-985-0054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization