Organization
PEACHTREE MENA LLC
Active
Other names
Peachtree Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL THOMAS SHEPARD I (MANAGING MEMBER)
(501) 276-8883
Entity
Organization
Contact information
Practice address
1803 CORDIE DR, MENA, AR 71953-9340
(479) 394-2600
(870) 540-0012
Mailing address
1803 CORDIE DR, MENA, AR 71953-9340
(479) 394-2600
(870) 540-0012
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/08/2008
Last updated
07/08/2008
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