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General NPI Number Information
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NPI Number | 1811227432
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Entity Type | Organization
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Legal Business Name | AUTUMN HILL, INC.
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Dates
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Enumeration Date | 01/04/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 500 HAMMONS AVE
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City | BERRYVILLE
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State | AR
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Zip | 72616-4300
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Country | US
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Telephone | 870-423-6966
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 MAIN ST
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City | VAN BUREN
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State | AR
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Zip | 72956-4957
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Country | US
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Telephone | 479-474-6885
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Fax | 479-474-9523
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Authorized Official
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Title or Position | CFO
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Name | JENNY KILGORE
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Credential |
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Telephone | 479-474-6885
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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 | 758
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License Number State | AR
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