Organization
MONTGOMERY COUNTY ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN FREDRICK WANN (ADMINISTRATOR)
(870) 867-2156
Entity
Organization
Contact information
Practice address
741 SOUTH DRIVE, MOUNT IDA, AR 71957
(870) 867-2156
(870) 867-2049
Mailing address
PO BOX 1208, MOUNT IDA, AR 71957-1208
(870) 867-2156
(870) 867-2049
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
023
AR
Other
Enumeration date
06/25/2007
Last updated
08/22/2020
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