Healthcare Provider Details

I. General information

NPI: 1487138954
Provider Name (Legal Business Name): HOT SPRINGS NURSING AND REHABILITATION - A WATERS COMMUNITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2821 W DIXON RD
LITTLE ROCK AR
72206-4256
US

IV. Provider business mailing address

552 GOLF LINKS RD
HOT SPRINGS AR
71901-7917
US

V. Phone/Fax

Practice location:
  • Phone: 501-888-4200
  • Fax:
Mailing address:
  • Phone: 501-624-7149
  • 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: MICHAEL BLISKO
Title or Position: MBR
Credential:
Phone: 708-449-1900