Provider Demographics
NPI:1144791559
Name:THE VILLAGES OF GENERAL BAPTIST HEALTH CARE ASSISTED LIVING
Entity Type:Organization
Organization Name:THE VILLAGES OF GENERAL BAPTIST HEALTH CARE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-598-1020
Mailing Address - Street 1:1287 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:PIGGOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72454-1010
Mailing Address - Country:US
Mailing Address - Phone:870-598-1020
Mailing Address - Fax:870-598-1025
Practice Address - Street 1:7001 S HAZEL ST
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7833
Practice Address - Country:US
Practice Address - Phone:870-535-9283
Practice Address - Fax:870-535-9288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility