Healthcare Provider Details
I. General information
NPI: 1639538390
Provider Name (Legal Business Name): HIGHLANDS OF MOUNTAIN VIEW RCF HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/23/2016
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
414 MASSEY AVE
MOUNTAIN VIEW AR
72560-6132
US
IV. Provider business mailing address
414 MASSEY AVE
MOUNTAIN VIEW AR
72560-6132
US
V. Phone/Fax
- Phone: 870-269-5845
- Fax: 870-269-2172
- Phone: 870-269-5845
- Fax: 870-269-2172
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 311Z00000X |
| Taxonomy | Custodial Care Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
SCHWARTZ
Title or Position: MANAGER
Credential:
Phone: 201-635-1195