| NPI | 1922677129 |
|---|---|
| Doing Business As | LAKE VILLAGE REHABILITATION AND CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | JOHN SHANNON FLEMING Sole Mbr 501-835-3988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-06-22 |