NPI 1124109749

Sequoyah Residential Facility, INC.

Organisation Nursing Facility/Intermediate Care Facility Prairie Grove, AR

Practice location

Address: 621 S Mock St, Prairie Grove, AR 72753-3146
Phone: (479) 846-2169
Mailing address: PO Box 916, Prairie Grove, AR 72753-0916

Authorised official

Name: Eddie Martin
Title: Owner
Phone: (479) 846-2169

Registered specialties

Nursing Facility/Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 313M00000X Licence 777 (AR)

Other Nursing Facility/Intermediate Care Facility providers in Arkansas →

Registry record

NPI: 1124109749
Entity type: Organization
NPI issued: 18 Oct 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.