Organization
COUNTRY CLUB GARDENS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL S. MORTON (MEMBER)
(479) 783-4672
Entity
Organization
Contact information
Practice address
120 PITTMAN RD, HOT SPRINGS, AR 71913-9001
(501) 767-7530
(501) 767-7534
Mailing address
415 ROGERS AVE, FORT SMITH, AR 72901-1903
(479) 783-4672
(479) 783-2217
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187641311
—
AR
Enumeration date
03/22/2011
Last updated
04/17/2020
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