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Sequoyah Residential Facility, Inc. — NPI 1124109749, Prairie Grove, AR | NPI Central

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NPI 1124109749

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Sequoyah Residential Facility, Inc.

NPI 1124109749 · Nursing Facility/Intermediate Care Facility · Prairie Grove, AR

Provider details

NPI number: 1124109749
Entity type: Organization
Primary specialty: Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Organization subpart: No
Authorized official: Eddie Martin, Owner(479) 846-2169
License: 777 (AR)

Specialties & taxonomies

Nursing Facility/Intermediate Care FacilityPrimary313M00000XLicense 777 (AR)
Nursing & Custodial Care Facilities

Practice location

621 S Mock St

Prairie Grove, AR 72753-3146

Phone: (479) 846-2169

Approximate (ZIP-level) locationGet directions

More AR providers

Mailing address

Po Box 916

Prairie Grove, AR 72753-0916

Other names (DBA / former)

Doing business as: Medi Home of Prairie Grove

Registry dates

Enumerated: 2006-10-18
Last updated: 2020-08-22

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.