| NPI | 1639480049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRIE J THOMPSON Nurse Manager 870-268-6100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: AR P00932) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AR R09418) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2010-06-30 |