Organization
MEDICALODGES, INC.
Active
Other names
Gran Villas Texarkana
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY W FISHER (CHIEF FINANCIAL OFFICER)
(620) 251-6700
Entity
Organization
Contact information
Practice address
1625 E 42ND ST, TEXARKANA, AR 71854-1654
(870) 772-0689
(870) 772-1103
Mailing address
1625 E 42ND ST, TEXARKANA, AR 71854-1654
(870) 772-0689
(870) 772-1103
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
427
AR
261QA0600X
Adult Day Care Clinic/Center
Primary
427
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427
—
AR
Enumeration date
11/02/2006
Last updated
06/23/2008
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