NPI 1275673642
Countryside Manor LLC
Practice location
- Address
- 300 S Thompson Rd, Lamar, AR 72846-9423
- Phone
- (479) 754-2052
- Fax
- (479) 754-5745
Authorised official
- Name
- Justin Price
- Title
- Member
- Phone
- (918) 967-9285
Registered specialties
Nursing Facility/Intermediate Care Facility
Primary
Registry record
- NPI
- 1275673642
- Entity type
- Organization
- NPI issued
- 7 Feb 2007
- Record last updated
- 19 Feb 2008
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.