| NPI | 1699765958 |
|---|---|
| Doing Business As | LEGACY LODGE NURSING HOME |
| Entity Type | Organization |
| Authorized Contact | REBECCA BRASHEAR Administrator 479-968-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: AR 037) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-11-29 |