Organization
PEACHTREE LANE AT MENA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE LANDRUM (MANAGING MEMBER OWNER)
(479) 783-0718
Entity
Organization
Contact information
Practice address
1803 CORDIE DR, MENA, AR 71953-9340
(479) 394-2600
(479) 394-2608
Mailing address
1422 FRESNO ST, FORT SMITH, AR 72901-7065
(479) 783-0718
(479) 783-8564
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
008
AR
Other
Enumeration date
04/20/2007
Last updated
08/22/2020
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