Healthcare Provider Details

I. General information

NPI: 1851387187
Provider Name (Legal Business Name): NORTHWEST HEALTH AND REHAB, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 E APPLEBY RD
FAYETTEVILLE AR
72703-3902
US

IV. Provider business mailing address

27 E APPLEBY RD
FAYETTEVILLE AR
72703-3902
US

V. Phone/Fax

Practice location:
  • Phone: 479-444-9000
  • Fax: 479-444-9090
Mailing address:
  • Phone: 479-444-9000
  • Fax: 479-444-9090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number754
License Number StateAR

VIII. Authorized Official

Name: A BRANDON ADAMS
Title or Position: PRESIDENT
Credential:
Phone: 501-932-0050