Organization
CRESTPARK MARIANNA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BARBARA BELEW (MANAGER)
(501) 626-7986
Entity
Organization
Contact information
Practice address
700 W CHESTNUT ST, MARIANNA, AR 72360-2160
(870) 295-3466
(870) 295-5474
Mailing address
PO BOX 386, MARIANNA, AR 72360-0386
(870) 295-3466
(870) 295-5474
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
634
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045449
MEDICARE TPIN
AR
05
—
178269311
—
AR
Enumeration date
11/18/2008
Last updated
05/15/2015
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