| NPI | 1023103918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA BROADDRICK President 479-474-8021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AR 109182311) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2020-08-22 |