Healthcare Provider Details
I. General information
NPI: 1548634074
Provider Name (Legal Business Name): SOMERSET SENIOR LIVING AT PREMIER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/20/2015
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3600 RICHARDS RD
NORTH LITTLE ROCK AR
72117-2921
US
IV. Provider business mailing address
3600 RICHARDS RD
NORTH LITTLE ROCK AR
72117-2921
US
V. Phone/Fax
- Phone: 501-955-2108
- Fax: 501-955-9517
- Phone: 501-955-2108
- Fax: 501-955-9517
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:
LISA
FAIRCHILD
Title or Position: ADMINISTRATOR
Credential:
Phone: 501-955-2108