Healthcare Provider Details

I. General information

NPI: 1710207915
Provider Name (Legal Business Name): SALINE OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19701 INTERSTATE 30
BENTON AR
72015-8024
US

IV. Provider business mailing address

2230 S MACARTHUR DR SUITE 9
ALEXANDRIA LA
71301-3057
US

V. Phone/Fax

Practice location:
  • Phone: 501-778-8200
  • Fax: 501-778-9652
Mailing address:
  • Phone: 501-778-8200
  • Fax: 501-778-9652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. EARNEST JOHNSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 501-778-8200