NPI: 1245509504 · WHITE OAK, TX 75693 · Contractor · NPI assigned 12/15/2011
| Authorized Official | POLK, LA TONYA (PROGRAM MANAGER) |
| NPI Enumeration Date | 12/15/2011 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 28 | $3K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| S5101 | Day care services, adult; per half day | 28 | 14 | $3K |