Provider Demographics
NPI:1588321186
Name:NECOLE'S LEARNING ACADEMY LLC.
Entity type:Organization
Organization Name:NECOLE'S LEARNING ACADEMY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:CHAQUARRA
Authorized Official - Middle Name:LASTAYSHA
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:903-787-2219
Mailing Address - Street 1:1738 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-5831
Mailing Address - Country:US
Mailing Address - Phone:903-284-6327
Mailing Address - Fax:
Practice Address - Street 1:1738 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-5831
Practice Address - Country:US
Practice Address - Phone:903-284-6327
Practice Address - Fax:900-393-1184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty