Healthcare Provider Details

I. General information

NPI: 1336695477
Provider Name (Legal Business Name): LONOKE HEALTHCARE CENTER AND REHABILITATION FACILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 09/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 BARNES ST
LONOKE AR
72086-2003
US

IV. Provider business mailing address

1010 BARNES ST
LONOKE AR
72086-2003
US

V. Phone/Fax

Practice location:
  • Phone: 501-676-3103
  • Fax: 501-676-7730
Mailing address:
  • Phone: 501-676-3103
  • Fax: 501-676-7730

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: JOSEPH SCHWARTZ
Title or Position: MEMBER
Credential:
Phone: 201-635-1195