Healthcare Provider Details

I. General information

NPI: 1104134501
Provider Name (Legal Business Name): NHO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 09/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 W COLLIN RAYE DR
DE QUEEN AR
71832-2030
US

IV. Provider business mailing address

1206 W COLLIN RAYE DR
DE QUEEN AR
71832-2030
US

V. Phone/Fax

Practice location:
  • Phone: 870-642-3317
  • Fax:
Mailing address:
  • Phone: 870-642-3317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number778
License Number StateAR

VIII. Authorized Official

Name: STEVE MARINICK
Title or Position: OWNER
Credential:
Phone: 501-545-9009