Organization
TWIN LAKES THERAPY & LIVING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY HARGIS (PRESIDENT)
(870) 368-4050
Entity
Organization
Contact information
Practice address
600 NORTH MAIN, SUITE A, MELBOURNE, AR 72556
(870) 368-4050
(870) 368-4054
Mailing address
6152 HIGHWAY 202 E, FLIPPIN, AR 72634-9726
(870) 453-4603
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190782311
—
AR
Enumeration date
03/05/2012
Last updated
03/21/2012
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