| NPI | 1295071322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY CAMILLE BICKERSTAFF Apn 501-909-1153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AR A03082) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2012-12-18 |