Organization
CHICOT SNF OPERATIONS LLC
Active
Other names
LAKE VILLAGE REHABILIATION AND CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROSS PONTHIE (MEMBER)
(318) 443-8167
Entity
Organization
Contact information
Practice address
903 BORGOGNONI DR, LAKE VILLAGE, AR 71653-1623
(870) 265-5337
(870) 265-3275
Mailing address
903 BORGOGNONI DR, LAKE VILLAGE, AR 71653-1623
(870) 265-5337
(870) 265-3275
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
AR
Other
Enumeration date
09/07/2010
Last updated
07/13/2020
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