Healthcare Provider Details

I. General information

NPI: 1467934364
Provider Name (Legal Business Name): LTC OF ROGERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 N 22ND ST
ROGERS AR
72756-2200
US

IV. Provider business mailing address

2600 N 22ND ST
ROGERS AR
72756-2200
US

V. Phone/Fax

Practice location:
  • Phone: 479-899-6778
  • Fax:
Mailing address:
  • Phone: 479-899-6778
  • Fax:

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: CARLA HEDRICK
Title or Position: CFO
Credential: CFO
Phone: 573-481-9625