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Organization
SEQUOYAH RESIDENTIAL FACILITY, INC.
Active
Organization
SEQUOYAH RESIDENTIAL FACILITY, INC.
Active
Other names
Medi Home of Prairie Grove
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE MARTIN (OWNER)
(479) 846-2169
Entity
Organization
Contact information
Practice address
621 S MOCK ST, PRAIRIE GROVE, AR 72753-3146
(479) 846-2169
Mailing address
PO BOX 916, PRAIRIE GROVE, AR 72753-0916
(479) 846-2169
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
777
AR
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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