Organization
SPLIT RAIL INC.
Active
Other names
Split Rail Residential Care Facility
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY MAE ROACH (ADMINISTRATOR)
(870) 887-2653
Entity
Organization
Contact information
Practice address
1658 US HIGHWAY 371, PRESCOTT, AR 71857-7064
(870) 887-2653
(870) 887-2018
Mailing address
PO BOX 27, PRESCOTT, AR 71857-0027
(870) 887-2653
(870) 887-2018
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119086732
—
AR
Enumeration date
03/11/2019
Last updated
03/11/2019
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