# WOODRUFF COUNTY HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** John Davis Woodruff Center Residential Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679574727
- **Authorized official:** MRS. GWEN S BROGDON (ADMINISTRATOR)
- **Authorized official phone:** (870) 731-2543

## Contact information

- **Practice address:** HWY 64 W, \# 139, MC CRORY, AR 72101-8223
- **Practice address phone:** (870) 731-2543
- **Practice address fax:** (870) 731-5027
- **Mailing address:** HWY 64 W, \# 139, MC CRORY, AR 72101-8223
- **Mailing address phone:** (870) 731-2543
- **Mailing address fax:** (870) 731-5027

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 220 | AR | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 057 | AR | Yes |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 07/23/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 95847673 | DEFENSE LOGISTICS AGENCY | — |
| 01 | — | G24681012 | DEPT OF VETERAN AFFAIRS | AR |