| NPI | 1902869787 |
|---|---|
| Doing Business As | FOUNTAIN LAKE HEALTH AND REHAB |
| Entity Type | Organization |
| Authorized Contact | JOEY MARTIN WIGGINS President 501-305-3153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: AR 681) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2020-08-22 |