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 |