Organization
PINE LANE THERAPY AND LIVING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBU HARGIS (PRESIDENT)
(870) 368-4050
Entity
Organization
Contact information
Practice address
1100 PINETREE LN, MOUNTAIN HOME, AR 72653-4502
(870) 425-6316
(870) 425-5197
Mailing address
1100 PINETREE LN, MOUNTAIN HOME, AR 72653-4502
(870) 425-6316
(870) 425-5197
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
720
AR
Other
Enumeration date
05/27/2010
Last updated
07/21/2010
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