Healthcare Provider Details

I. General information

NPI: 1386140341
Provider Name (Legal Business Name): THREE RIVERS NURSING AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 05/07/2021
Certification Date: 05/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33904 HIGHWAY 63 E
MARKED TREE AR
72365-9521
US

IV. Provider business mailing address

33904 HIGHWAY 63 E
MARKED TREE AR
72365-9521
US

V. Phone/Fax

Practice location:
  • Phone: 970-358-2432
  • Fax: 870-358-4582
Mailing address:
  • Phone: 970-358-2432
  • Fax: 870-358-4582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateAR

VIII. Authorized Official

Name: BONNIE QUIBODEAUX
Title or Position: CFO
Credential:
Phone: 225-769-7960