Healthcare Provider Details

I. General information

NPI: 1225454325
Provider Name (Legal Business Name): MHPNC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2014
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 PINETREE LN
MOUNTAIN HOME AR
72653-4502
US

IV. Provider business mailing address

1100 PINETREE LN
MOUNTAIN HOME AR
72653-4502
US

V. Phone/Fax

Practice location:
  • Phone: 870-425-6316
  • Fax: 870-424-5197
Mailing address:
  • Phone: 870-232-0320
  • Fax: 870-232-0326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1049
License Number StateAR

VIII. Authorized Official

Name: BRANDON ADAMS
Title or Position: PRESIDENT
Credential:
Phone: 501-932-0050