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Organization

INDIAN ROCK VILLAGE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EDWARD VICTOR HOLMAN (PRESIDENT)
(501) 224-0846
Entity
Organization

Contact information

Practice address
265 DAVE CREEK PARKWAY, FAIRFIELD BAY, AR 72088-3136
(501) 884-3210
(501) 884-6800
Mailing address
265 DAVE CREEK PKWY, FAIRFIELD BAY, AR 72088-3106
(501) 884-3210
(501) 884-6800

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
452
AR

Other

Enumeration date
05/10/2006
Last updated
12/04/2013
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