Healthcare Provider Details
I. General information
NPI: 1659100980
Provider Name (Legal Business Name): HOT SPRINGS SNF OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2024
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
121 CORTEZ RD
HOT SPRINGS AR
71909-6101
US
IV. Provider business mailing address
180 SYLVAN AVE STE 202
ENGLEWOOD CLIFFS NJ
07632-2512
US
V. Phone/Fax
- Phone: 501-922-2000
- Fax:
- Phone: 718-570-6018
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DANIEL
MANDELBAUM
Title or Position: CFO
Credential: CPA
Phone: 718-570-6018