Provider Demographics
NPI:1467663880
Name:GRAHAM'S FOSTER HOME FOR THE ELDERLY
Entity Type:Organization
Organization Name:GRAHAM'S FOSTER HOME FOR THE ELDERLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-843-5968
Mailing Address - Street 1:692 HONEYSUCKLE LN
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-8276
Mailing Address - Country:US
Mailing Address - Phone:501-843-5968
Mailing Address - Fax:501-941-2075
Practice Address - Street 1:692 HONEYSUCKLE LN
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-8276
Practice Address - Country:US
Practice Address - Phone:501-843-5968
Practice Address - Fax:501-941-2075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR415310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility