Healthcare Provider Details

I. General information

NPI: 1255399424
Provider Name (Legal Business Name): CABOT HEALTHCARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 HIGHWAY 367 N
AUSTIN AR
72007-8003
US

IV. Provider business mailing address

PO BOX 1313
CABOT AR
72023-1313
US

V. Phone/Fax

Practice location:
  • Phone: 501-941-1495
  • Fax: 501-941-1496
Mailing address:
  • Phone: 501-941-1495
  • Fax: 501-941-1496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JACK WEIR
Title or Position: CEO
Credential:
Phone: 501-941-1495