MEDICARE: ARKANSAS CONTINUED CARE HOSPITAL OF JONESBORO, 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	313M00000X	Nursing Facility/Intermediate Care Facility

General Provider Information

NPI Number	:	1821788589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARKANSAS CONTINUED CARE HOSPITAL OF JONESBORO, LLC

Provider Business Mailing Address
First Line	:	3024 RED WOLF BLVD STE 1
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72401-7431
Country	:	US
Telephone Number	:	870-819-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	3024 RED WOLF BLVD STE 1
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72401-7431
Country	:	US
Telephone Number	:	870-819-4040
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JAMES COX
Credential	:
Telephone Number	:	870-819-4040

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	05/08/2023

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