MEDICARE: THE PLAZA AT TWIN RIVERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	063	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952674384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE PLAZA AT TWIN RIVERS

Provider Business Mailing Address
First Line	:	3007 TWIN RIVERS DR
Second Line	:
City	:	ARKADELPHIA
State	:	AR
Zip	:	71923-4219
Country	:	US
Telephone Number	:	870-230-1490
Fax Number	:	870-230-1491

Provider Business Practice Location Address
First Line	:	3007 TWIN RIVERS DR
Second Line	:
City	:	ARKADELPHIA
State	:	AR
Zip	:	71923-4219
Country	:	US
Telephone Number	:	870-230-1490
Fax Number	:	870-230-1491

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TAMARA BELL
Credential	:
Telephone Number	:	870-403-6201

Provider Enumeration Date	:	02/15/2012
Last Update Date	:	02/15/2012

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Directions to “THE PLAZA AT TWIN RIVERS ” Practice Location

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