NPI 1780633222
Indian Rock Village, LLC
Practice location
- Address
- 265 Dave Creek Parkway, Fairfield Bay, AR 72088-3136
- Phone
- (501) 884-3210
- Fax
- (501) 884-6800
- Mailing address
- 265 Dave Creek Pkwy, Fairfield Bay, AR 72088-3106
Authorised official
- Name
- Edward Victor Holman
- Title
- President
- Phone
- (501) 224-0846
Registered specialties
Nursing Facility/Intermediate Care Facility
Primary
Registry record
- NPI
- 1780633222
- Entity type
- Organization
- NPI issued
- 10 May 2006
- Record last updated
- 4 Dec 2013
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.