04D2194582 CLIA NUMBER - WINDSOR COTTAGE INDEPENDENT AND ASSISTED LIVING

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Laboratory Demographics

CLIA Number: 04D2194582

Facility Name: WINDSOR COTTAGE INDEPENDENT AND ASSISTED LIVING

Facility Address:
4110 JEFFERSON AVE
TEXARKANA, AR
ZIP 71854
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Facility Phone Number: 870 773-0417

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1316370109

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	04D2194582
LAB Type	Assisted Living Facility
Facility Name	WINDSOR COTTAGE INDEPENDENT AND ASSISTED LIVING
Street	4110 JEFFERSON AVE
City	TEXARKANA
State	AR
ZIP	71854
Phone	870 773-0417
CertificateType	4
CertificateEffectiveDate	10/1/2022
CertificateExpirationDate	9/30/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024