Healthcare Provider Details

I. General information

NPI: 1356856637
Provider Name (Legal Business Name): OAKLAWN ESTATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 12/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S LAUREL ST
HOPE AR
71801-8221
US

IV. Provider business mailing address

1901 S LAUREL ST
HOPE AR
71801-8221
US

V. Phone/Fax

Practice location:
  • Phone: 870-777-8855
  • Fax: 870-777-8462
Mailing address:
  • Phone: 870-777-8855
  • Fax: 870-777-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number938
License Number StateAR

VIII. Authorized Official

Name: MRS. CATHY L PARSONS
Title or Position: MANAGING MEMBER
Credential:
Phone: 870-530-3837