Healthcare Provider Details

I. General information

NPI: 1386127488
Provider Name (Legal Business Name): CHC GOSNELL HEALTH AND REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MOODY ST
GOSNELL AR
72315-6110
US

IV. Provider business mailing address

305 HIGHWAY 64 E STE D
AUGUSTA AR
72006-5158
US

V. Phone/Fax

Practice location:
  • Phone: 870-532-5550
  • Fax: 870-532-5600
Mailing address:
  • Phone: 870-347-0001
  • Fax:

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: BOYD WRIGHT
Title or Position: COO
Credential:
Phone: 870-347-0001