Organization
KSJ, LLC
Active
Other names
Prescott Manor Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH HEAD (MANAGING PARTNER)
(870) 887-6639
Entity
Organization
Contact information
Practice address
700 MANOR RD, PRESCOTT, AR 71857-2800
(870) 887-6639
(870) 887-6690
Mailing address
700 MANOR RD, PRESCOTT, AR 71857-2800
(870) 887-6639
(870) 887-6690
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0613
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119673311
—
AR
Enumeration date
08/02/2006
Last updated
04/22/2008
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