| NPI | 1114030269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES EDWARD MITCHELL Administrator 479-495-2914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AR 045454) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AR 073) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2015-01-16 |