Healthcare Provider Details

I. General information

NPI: 1407155237
Provider Name (Legal Business Name): THE GARDENS AT WHISPERING KNOLL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6814 S HAZEL ST
PINE BLUFF AR
71603-7828
US

IV. Provider business mailing address

6814 S HAZEL ST
PINE BLUFF AR
71603-7828
US

V. Phone/Fax

Practice location:
  • Phone: 870-850-2923
  • Fax:
Mailing address:
  • Phone: 870-850-2923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number50
License Number StateAR

VIII. Authorized Official

Name: MRS. NINA HUNT
Title or Position: ADMINISTRATOR
Credential:
Phone: 870-850-2923