MEDICARE: CABOT NURSING AND REHABILITATION CENTER, 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
1	314000000X	Skilled Nursing Facility	771	AR

General Provider Information

NPI Number	:	1205824851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CABOT NURSING AND REHABILITATION CENTER, LLC

Provider Business Mailing Address
First Line	:	200 NORTHPORT DR
Second Line	:
City	:	CABOT
State	:	AR
Zip	:	72023-6002
Country	:	US
Telephone Number	:	501-843-6181
Fax Number	:	501-843-6736

Provider Business Practice Location Address
First Line	:	200 NORTHPORT DR
Second Line	:
City	:	CABOT
State	:	AR
Zip	:	72023-6002
Country	:	US
Telephone Number	:	501-843-6181
Fax Number	:	501-843-6736

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. SHEILA MARTIN
Credential	:
Telephone Number	:	501-843-6181

Provider Enumeration Date	:	10/07/2005
Last Update Date	:	08/22/2020

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