Organization
KMJ ENTERPRISES BENTONVILLE MANOR LLC
Active
Parent organization
KMJ MANAGEMENT
Other names
Bentonville Manor Nursing Home
Organization subpart
Yes
Provider details
NPI number
Legal business name
KMJ MANAGEMENT
Authorized official
MS. PATRICIA MILLER (PRESIDENT/CEO)
(479) 636-5716
Entity
Organization
Contact information
Practice address
224 S MAIN ST, BENTONVILLE, AR 72712-5963
(479) 273-3373
(479) 273-0623
Mailing address
224 S MAIN ST, BENTONVILLE, AR 72712-5963
(479) 273-3373
(479) 273-0623
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
712
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119720311
—
AR
Enumeration date
09/30/2005
Last updated
06/10/2008
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