Organization
RIVER LODGE ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD PARKER HIGHTOWER (OWNER)
(479) 471-9797
Entity
Organization
Contact information
Practice address
117 RIVERLODGE DRIVE, MOUNTAIN HOME, AR 72653
(870) 607-0902
(870) 607-0905
Mailing address
217 LAKEWOOD RD, VAN BUREN, AR 72956-8120
(479) 471-9797
(479) 471-7559
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
049
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185308794
—
AR
Enumeration date
05/12/2011
Last updated
05/12/2011
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