Healthcare Provider Details

I. General information

NPI: 1366809956
Provider Name (Legal Business Name): GLENWOOD HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2016
Last Update Date: 01/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 MOUNTAIN VIEW RD
GLENWOOD AR
71943-9061
US

IV. Provider business mailing address

615 MOUNTAIN VIEW RD
GLENWOOD AR
71943-9061
US

V. Phone/Fax

Practice location:
  • Phone: 870-782-4437
  • Fax: 870-356-4314
Mailing address:
  • Phone: 870-782-4437
  • Fax: 870-356-4314

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: JOSEPH SCHWARTZ
Title or Position: MANAGER
Credential:
Phone: 201-635-1195