Organization
COUNTRYSIDE HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA HELEN BOX BSBA (ADMINISTRATOR)
(479) 738-1500
Entity
Organization
Contact information
Practice address
722 PHILLIPS PL, HUNTSVILLE, AR 72740-9517
(479) 738-1500
Mailing address
722 PHILLIPS PL, HUNTSVILLE, AR 72740-9517
(479) 738-1500
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
AR
Other
Enumeration date
01/19/2009
Last updated
01/19/2009
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