Organization
STAP, INC.
Active
Other names
St. Andrews Place
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY JUNE KILGORE CPA (CFO)
(479) 474-6885
Entity
Organization
Contact information
Practice address
3501 COLLEGE AVE, CONWAY, AR 72034-7281
(501) 329-9879
(501) 329-6673
Mailing address
2010 MAIN ST, VAN BUREN, AR 72956-4957
(479) 474-6885
(479) 474-9523
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181708311
—
AR
Enumeration date
05/03/2010
Last updated
06/10/2010
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