Healthcare Provider Details

I. General information

NPI: 1871897041
Provider Name (Legal Business Name): JAMESTOWN NURSING AND REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S HAMPTON PL
ROGERS AR
72758-1352
US

IV. Provider business mailing address

415 ROGERS AVE
FORT SMITH AR
72901-1903
US

V. Phone/Fax

Practice location:
  • Phone: 479-986-9945
  • Fax:
Mailing address:
  • Phone: 479-783-4672
  • Fax: 479-783-2217

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: MR. MICHAEL S. MORTON
Title or Position: MEMBER
Credential:
Phone: 479-783-4672