Provider Demographics
NPI:1609072529
Name:FL & B
Entity Type:Organization
Organization Name:FL & B
Other - Org Name:THE PILLARS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-364-2474
Mailing Address - Street 1:PO BOX 1116
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-1116
Mailing Address - Country:US
Mailing Address - Phone:870-364-2474
Mailing Address - Fax:870-364-3909
Practice Address - Street 1:400 MAIN ST
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-2963
Practice Address - Country:US
Practice Address - Phone:870-364-2474
Practice Address - Fax:870-364-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR022310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR163934794Medicaid