Healthcare Provider Details
I. General information
NPI: 1679140651
Provider Name (Legal Business Name): ARKANSAS HEALTH & REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/08/2021
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1515 N CENTER ST STE 5
LONOKE AR
72086-2100
US
IV. Provider business mailing address
PO BOX 5718
KALISPELL MT
59903-5718
US
V. Phone/Fax
- Phone: 501-676-5540
- Fax: 501-676-6499
- Phone: 406-756-0134
- Fax: 406-300-1612
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BLAINE
STIMAC
Title or Position: MANAGING MEMBER
Credential: MSPT
Phone: 406-756-1128