Organization
GYMAN LLC
Active
Other names
Golden Years Manor
Organization subpart
No
Provider details
NPI number
Authorized official
JOEY MARTIN WIGGINS (PRESIDENT)
(501) 305-3153
Entity
Organization
Contact information
Practice address
1010 BARNES STREET, LONOKE, AR 72086
(501) 676-3103
(501) 676-7730
Mailing address
2908 HAWKINS DRIVE, SEARCY, AR 72143
(501) 305-3153
(501) 279-3796
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
730
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015314
MEDIPAK
AR
Enumeration date
04/11/2006
Last updated
08/22/2020
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