Healthcare Provider Details

I. General information

NPI: 1841405040
Provider Name (Legal Business Name): HIGHLAND COURT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SOUTH CEDAR ST
MARSHALL AR
72650
US

IV. Provider business mailing address

PO BOX 541
MARSHALL AR
72650-0541
US

V. Phone/Fax

Practice location:
  • Phone: 870-448-3577
  • Fax: 870-448-4884
Mailing address:
  • Phone: 870-448-3577
  • Fax: 870-448-4884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number839
License Number StateAR

VIII. Authorized Official

Name: MARLA E. REECE
Title or Position: ADMINISTRATOR
Credential:
Phone: 870-448-3577