Healthcare Provider Details

I. General information

NPI: 1528563244
Provider Name (Legal Business Name): VAUGHT CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2018
Last Update Date: 03/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 W MAIN ST
HORATIO AR
71842-0308
US

IV. Provider business mailing address

206 W MAIN ST PO BOX 308
HORATIO AR
71842-0308
US

V. Phone/Fax

Practice location:
  • Phone: 870-832-5848
  • Fax: 870-832-0206
Mailing address:
  • Phone: 870-832-5848
  • Fax: 870-832-0206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EMILEE VAUGHT
Title or Position: OWNER/PROVIDER
Credential: DNP, APRN
Phone: 870-832-5848