Healthcare Provider Details

I. General information

NPI: 1487570347
Provider Name (Legal Business Name): POCAHONTAS OPERATING SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 COUNTRY CLUB RD
POCAHONTAS AR
72455-1364
US

IV. Provider business mailing address

105 COUNTRY CLUB RD
POCAHONTAS AR
72455-1364
US

V. Phone/Fax

Practice location:
  • Phone: 732-646-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: ESTI PRUZANSKY
Title or Position: AR DIRECTOR
Credential:
Phone: 732-646-7200