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General NPI Number Information
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NPI Number | 1710971809
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Entity Type | Organization
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Legal Business Name | HUDSON MEMORIAL NURSING HOME
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 700 N COLLEGE AVE
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City | EL DORADO
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State | AR
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Zip | 71730-4404
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Country | US
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Telephone | 870-863-8131
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Fax | 870-863-8661
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Provider Business Mailing Address
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Address Line | 700 N COLLEGE AVE
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City | EL DORADO
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State | AR
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Zip | 71730-4404
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Country | US
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Telephone | 870-863-8131
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Fax | 870-863-8661
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. BILL YUTZY
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Credential |
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Telephone | 870-863-8131
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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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