| Grand Manor | |
|
1960 Highway 425 N Monticello AR 71655-8862 | |
| (870) 412-4400 | |
| (870) 412-4506 |
| Full Name | Grand Manor |
|---|---|
| Speciality | Clinic/center |
| Location | 1960 Highway 425 N, Monticello, Arkansas |
| Authorized Official Name and Position | Jennifer L Helms (SECRETARY) |
| Authorized Official Contact | 8704124400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Manor 1960 Highway 425 N Monticello AR 71655-8862 Ph: (870) 412-4400 | Grand Manor 1960 Highway 425 N Monticello AR 71655-8862 Ph: (870) 412-4400 |
| NPI Number | 1508251786 |
|---|---|
| Provider Enumeration Date | 04/03/2015 |
| Last Update Date | 04/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508251786 | NPI | - | NPPES |
| 206724794 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 106 (Arkansas) | Primary |
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