Provider Demographics
NPI:1427778620
Name:LITTLE NIGHT OWLS EVENING CARE
Entity type:Organization
Organization Name:LITTLE NIGHT OWLS EVENING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-351-6269
Mailing Address - Street 1:705 ORION DR
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-3472
Mailing Address - Country:US
Mailing Address - Phone:318-351-6269
Mailing Address - Fax:
Practice Address - Street 1:705 ORION DR
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-3472
Practice Address - Country:US
Practice Address - Phone:318-351-6269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals