Healthcare Provider Details

I. General information

NPI: 1710267802
Provider Name (Legal Business Name): HOT SPRINGS COMPREHENSIVE THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2278 ALBERT PIKE ROAD STE B
HOT SPRINGS AR
71913-4157
US

IV. Provider business mailing address

2675 COURT DR
GASTONIA NC
28054-1478
US

V. Phone/Fax

Practice location:
  • Phone: 501-767-0808
  • Fax: 501-767-0832
Mailing address:
  • Phone: 704-824-7800
  • Fax: 704-824-7898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: REBECCA T. HUMPHRIES
Title or Position: BILLING/CREDENTIAL SUPERVISOR
Credential:
Phone: 704-824-7800