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General NPI Number Information
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NPI Number | 1588333223
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Entity Type | Organization
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Legal Business Name | PROMISE LAND ESTATES, LLC
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Dates
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Enumeration Date | 09/07/2021
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 1411 MAPLE ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-4134
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Country | US
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Telephone | 501-539-4470
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Fax | 501-791-3120
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Provider Business Mailing Address
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Address Line | 1411 MAPLE ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-4134
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Country | US
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Telephone | 501-539-4770
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Fax | 501-436-0908
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Authorized Official
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Title or Position | MANAGER
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Name | MISS AVIS DENISE WINSTON
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Credential |
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Telephone | 501-539-4470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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