Organization
WAGNON PLACE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHY SUE WAGNON (ADMINISTRATOR OWNER)
(870) 226-6766
Entity
Organization
Contact information
Practice address
1440 E CHURCH ST, WARREN, AR 71671-3528
(870) 226-6766
(870) 226-7430
Mailing address
PO BOX 230, WARREN, AR 71671-0230
(870) 226-6766
(870) 226-7430
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
328
AR
Other
Enumeration date
09/20/2005
Last updated
08/22/2020
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