Provider Demographics
NPI:1316417751
Name:MERRITT VENTURES, LLC, DBA: LICE CLINICS OF AMERICA - LITTLE ROCK
Entity type:Organization
Organization Name:MERRITT VENTURES, LLC, DBA: LICE CLINICS OF AMERICA - LITTLE ROCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-424-9396
Mailing Address - Street 1:1011 N 2ND ST STE D
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2751
Mailing Address - Country:US
Mailing Address - Phone:501-424-9396
Mailing Address - Fax:
Practice Address - Street 1:1011 N 2ND ST STE D
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2751
Practice Address - Country:US
Practice Address - Phone:501-424-9396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty