| NPI | 1255537486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN FREDRICK WANN Administrator 870-867-2156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AR 023) |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2020-08-22 |