Organization
STATE OF ARKANSAS
Active
Other names
Arkansas State Veterans Home at Fayetteville, Arkansas Veterans Home at Fayetteville
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CAPPIELLO (ADMINISTRATOR)
(479) 444-7001
Entity
Organization
Contact information
Practice address
1179 N. COLLEGE AVE., FAYETTEVILLE, AR 72703-1955
(479) 444-7001
(479) 695-0184
Mailing address
1179 N. COLLEGE AVE., FAYETTEVILLE, AR 72703-1955
(479) 444-7001
(479) 695-0184
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
803
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160958311
—
AR
Enumeration date
09/13/2006
Last updated
05/17/2024
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