| NPI | 1649407297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEENA SMITH Billing Dept 870-236-2762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2009-06-22 |