Organization
WOODRUFF COUNTY HEALTH CENTER
Active
Other names
John Davis Woodruff Center Residential Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GWEN S BROGDON (ADMINISTRATOR)
(870) 731-2543
Entity
Organization
Contact information
Practice address
HWY 64 W, # 139, MC CRORY, AR 72101-8223
(870) 731-2543
(870) 731-5027
Mailing address
HWY 64 W, # 139, MC CRORY, AR 72101-8223
(870) 731-2543
(870) 731-5027
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
220
AR
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
057
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95847673
DEFENSE LOGISTICS AGENCY
—
01
—
G24681012
DEPT OF VETERAN AFFAIRS
AR
Enumeration date
08/10/2005
Last updated
07/23/2007
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