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NPI Code Detail

MEDICARE: HIGHLANDS OF LITTLE ROCK RILEY HOLDINGS LLC

MEDICARE: HIGHLANDS OF LITTLE ROCK RILEY HOLDINGS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility1107AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063873537
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLANDS OF LITTLE ROCK RILEY HOLDINGS LLC
Provider Business Mailing Address
First Line : 8701 RILEY DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6509
Country : US
Telephone Number : 501-224-2700
Fax Number : 501-907-0629
Provider Business Practice Location Address
First Line : 8701 RILEY DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6509
Country : US
Telephone Number : 501-224-2700
Fax Number : 501-907-0629
Authorized Official
Title or Position : MANAGER
Name : JOSEPH SCHWARTZ
Credential :
Telephone Number : 201-635-1195
Provider Enumeration Date : 03/11/2016
Last Update Date : 05/10/2016

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