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General NPI Number Information
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NPI Number | 1972727287
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Entity Type | Organization
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Legal Business Name | THE CROSSING AT MALVERN
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 720 NORTH WALCO ROAD
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City | MALVERN
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State | AR
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Zip | 72104
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Country | US
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Telephone | 501-467-8488
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Fax | 501-467-8780
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Provider Business Mailing Address
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Address Line | 217 LAKEWOOD RD
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City | VAN BUREN
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State | AR
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Zip | 72956-8120
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Country | US
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Telephone | 479-471-9797
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Fax | 479-471-7559
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Authorized Official
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Title or Position | OWNER
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Name | MR. TODD PARKER HIGHTOWER
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Credential |
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Telephone | 479-471-9797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 021
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License Number State | AR
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