| NPI | 1053464826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM A. WICKIZER Administrator 479-442-7220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AR 365) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |