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General NPI Number Information
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NPI Number | 1033424833
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Entity Type | Organization
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Legal Business Name | CLARKSVILLE COMMUNITY HEALTH & REHABILITATION LLC
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Dates
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Enumeration Date | 08/17/2010
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 400 OAK CT
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City | CLARKSVILLE
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State | AR
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Zip | 72830-3778
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Country | US
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Telephone | 317-841-2377
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Fax |
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Provider Business Mailing Address
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Address Line | 9785 CROSSPOINT BLVD STE 104
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-3321
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Country | US
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Telephone | 317-598-9467
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Fax | 317-845-0616
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JERRY V. KEMPER
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Credential |
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Telephone | 317-598-9586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 945
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License Number State | AR
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