Organization
COUNTRYSIDE ASSISTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA H BOX (ADMINISTRATOR)
(479) 738-1500
Entity
Organization
Contact information
Practice address
722 PHILLIPS PL, HUNTSVILLE, AR 72740-9517
(479) 738-1500
(479) 738-1000
Mailing address
722 PHILLIPS PL, HUNTSVILLE, AR 72740-9517
(479) 738-1500
(479) 738-1000
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
037
AR
Other
Enumeration date
05/23/2011
Last updated
05/23/2011
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