Healthcare Provider Details
I. General information
NPI: 1669703187
Provider Name (Legal Business Name): ASHLEY NURSING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2010
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
114 CHESTER ASHLEY DR
CROSSETT AR
72635
US
IV. Provider business mailing address
299 S 24TH ST
ROGERS AR
72758-1102
US
V. Phone/Fax
- Phone: 479-636-5497
- Fax: 479-621-9095
- Phone: 479-636-5497
- Fax: 479-621-9095
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAVID
L
NORSWORTHY
Title or Position: CHEIF OPERATING OFFICER
Credential:
Phone: 479-636-5497