Provider Demographics
NPI:1003933409
Name:ROCKING CHAIR INN
Entity Type:Organization
Organization Name:ROCKING CHAIR INN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:Z.
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-756-9428
Mailing Address - Street 1:1232 WAGON WHEEL RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-7911
Mailing Address - Country:US
Mailing Address - Phone:479-756-9428
Mailing Address - Fax:479-756-6972
Practice Address - Street 1:1232 WAGON WHEEL RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-7911
Practice Address - Country:US
Practice Address - Phone:479-756-9428
Practice Address - Fax:479-756-6972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility