| NPI | 1528014487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER DALE TIDWELL Owner 870-285-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AR 548) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2008-02-22 |