# LAWRENCE MEMORIAL HEALTH FOUNDATION INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Imboden Rural Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346643020
- **Authorized official:** VANESSA K WAGNER (CFO)
- **Authorized official phone:** (870) 886-1263

## Contact information

- **Practice address:** 201 N WALNUT STREET, IMBODEN, AR 72434
- **Practice address phone:** (870) 869-3101
- **Practice address fax:** (870) 869-3014
- **Mailing address:** PO BOX 839, WALNUT RIDGE, AR 72476-0839
- **Mailing address phone:** (870) 886-1200
- **Mailing address fax:** (870) 886-5340

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | AR | Yes |

## Other

- **Enumeration date:** 10/08/2014
- **Last updated:** 08/30/2019