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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