Earth Angels Pediatric Day Center LLC

Primary specialty

Medically Fragile Infants and Children Day CareTaxonomy code 261QM3000X

Legal business name

EARTH ANGELS PEDIATRIC DAY CENTER LLC

Practice address

2045 N Hwy 360 Ste 100
Grand Prairie, TX 75050-1432

Phone

(954) 234-5589

NPI assigned

Jun 15, 2022

Last updated

Jun 15, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Victoria M Kelly

Title

Managing Member

Phone

(954) 234-5589

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1386374049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 BRIERFIELD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013047",
            "telephone_number": "954-234-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 N HWY 360 STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750501432",
            "telephone_number": "954-234-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARTH ANGELS PEDIATRIC DAY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "954-234-5589",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM3000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medically Fragile Infants and Children Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medically Fragile Infants and Children Day Care in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Medically Fragile Infants and Children Day Care in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.