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SEQUOYAH RESIDENTIAL FACILITY INC. NPI 1124109749


NPI Information

NPI: 1124109749
Provider Name: SEQUOYAH RESIDENTIAL FACILITY, INC.

Doing Business As: MEDI HOME OF PRAIRIE GROVE

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
621 S MOCK ST
PRAIRIE GROVE, AR
ZIP 72753
Phone: (479) 846-2169
Get Directions

SEQUOYAH RESIDENTIAL FACILITY, INC. is a nursing facility intermediate care facility in Prairie Grove, AR. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. SEQUOYAH RESIDENTIAL FACILITY, INC. NPI is 1124109749. The provider is registered as an organization entity type.
The provider Is Doing Business As Medi Home Of Prairie Grove.

The provider's business location address is:

621 S MOCK ST
PRAIRIE GROVE, AR
ZIP 72753-146
Phone: (479) 846-2169

The provider's authorized official is Eddie Martin .
The authorized official title is Owner and has the following contact phone number (479) 846-2169.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1313M00000XNursing Facility/Intermediate Care Facility777ARKANSASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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