| NPI | 1942344288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA DAMERON Office Clerk 870-494-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2020-08-22 |