Organization
MENA HEALTH, LLC
Active
Other names
Mena Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP CODY LONG (TREASURER & CFO)
(479) 464-0200
Entity
Organization
Contact information
Practice address
100 9TH ST, MENA, AR 71953-3026
(479) 394-2617
(479) 394-3928
Mailing address
222 S 1ST ST, ROGERS, AR 72756-4509
(479) 464-0200
(479) 464-8098
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201135311
—
AR
Enumeration date
12/03/2013
Last updated
11/06/2014
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