Organization
JACKSONVILLE CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY D SAMS (MEMBER)
(479) 783-4672
Entity
Organization
Contact information
Practice address
1500 GRAHAM RD, JACKSONVILLE, AR 72076-3837
(501) 982-5545
(501) 982-0016
Mailing address
415 ROGERS AVE, FORT SMITH, AR 72901-1903
(479) 783-4672
(479) 783-2217
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
502
AR
Other
Enumeration date
04/18/2017
Last updated
04/20/2020
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