Healthcare Provider Details

I. General information

NPI: 1467588335
Provider Name (Legal Business Name): MERCY CREST HOUSING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 STROZIER LN
BARLING AR
72923-2002
US

IV. Provider business mailing address

1300 STROZIER LN
BARLING AR
72923-2002
US

V. Phone/Fax

Practice location:
  • Phone: 479-478-3000
  • Fax: 479-452-8382
Mailing address:
  • Phone: 479-478-3000
  • Fax: 479-452-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number014
License Number StateAR

VIII. Authorized Official

Name: MRS. SANDRA LYNNE PRESSON
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 479-478-3000