Organization
STAR CITY NURSING CENTER, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH HEAD (MBR/PARTNER)
(870) 628-4295
Entity
Organization
Contact information
Practice address
505 E VICTORY ST, STAR CITY, AR 71667-5327
(870) 628-4295
(870) 628-5316
Mailing address
505 E VICTORY ST, STAR CITY, AR 71667-5327
(870) 628-4295
(870) 628-5316
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0704
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0704
LIC. #
AR
05
—
157584311
—
AR
Enumeration date
08/02/2006
Last updated
04/22/2008
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