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General NPI Number Information
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NPI Number | 1447530464
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Entity Type | Organization
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Legal Business Name | PLEASANT MANOR NURSING & REHAB
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 950 HOMESTEAD DR
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City | ASHDOWN
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State | AR
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Zip | 71822-4304
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Country | US
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Telephone | 870-898-5001
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Fax | 870-898-3342
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Provider Business Mailing Address
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Address Line | 950 HOMESTEAD DR
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City | ASHDOWN
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State | AR
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Zip | 71822-4304
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Country | US
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Telephone | 870-898-5001
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Fax | 870-898-3342
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES PICKETT
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Credential |
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Telephone | 870-898-5001
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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 | 951
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License Number State | AR
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