| NPI | 1083966352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY A JONES Secretary 479-201-4835 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: IA 00849) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |