- Enrollment id
- O20030514000043
- Enrollment state
- AR
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1619921061
- Multiple npi flag
- N
- Ccn
- 045384
- Associate id
- 3274443817
- Organization name
- T-LYNN INC.
- Doing business as name
- WOODBRIAR NURSING HOME
- Incorporation date
- 1998-09-01
- Incorporation state
- AR
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- WOODBRIAR NURSING HOME
- Address line 1
- 204 CATHERINE
- City
- HARRISBURG
- State
- AR
- Zip code
- 724321100