| NPI | 1376531202 |
|---|---|
| Doing Business As | SOUTHFORK RIVER THERAPY & LIVING CENTER |
| Entity Type | Organization |
| Authorized Contact | JOHNIECE TAYLOR Sec 870-368-4054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AR 760) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-09-25 |