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General NPI Number Information
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NPI Number | 1396028734
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Entity Type | Organization
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Legal Business Name | HOMESTEAD NURSING, LLC
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 826 NORTH ST
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City | STAMPS
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State | AR
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Zip | 71860-4522
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Country | US
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Telephone | 870-533-4444
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Fax | 870-533-8841
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Provider Business Mailing Address
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Address Line | 826 NORTH ST
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City | STAMPS
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State | AR
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Zip | 71860-4522
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Country | US
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Telephone | 870-533-4444
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Fax | 870-533-8841
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | BOYD GENTRY
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Credential |
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Telephone | 937-964-8974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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