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Organization

ST JOHN'S PLACE OF ARKANSAS, LLC

Active
Other names
St.John's Place
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN PONTHIE (MEMBER)
(318) 216-3316
Entity
Organization

Contact information

Practice address
1400 HIGHWAY 79 167 BYP, FORDYCE, AR 71742-1728
(870) 352-2104
(870) 352-8969
Mailing address
1400 HIGHWAY 79 167 BYP, FORDYCE, AR 71742-1728
(870) 352-2104
(870) 352-8969

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
832
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
162887311
AR
Enumeration date
04/26/2007
Last updated
02/20/2023
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