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General NPI Number Information
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NPI Number | 1164840260
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Entity Type | Organization
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Legal Business Name | HIGHLANDS OF HARRISON TIMS, LLC
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Dates
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Enumeration Date | 04/04/2014
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | 202 TIMS AVE
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City | HARRISON
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State | AR
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Zip | 72601-2229
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Country | US
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Telephone | 870-741-7667
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Fax | 870-741-6719
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Provider Business Mailing Address
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Address Line | 2 OFFICE PARK CIR SUITE 110
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City | MOUNTAIN BRK
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State | AL
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Zip | 35223-2509
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Country | US
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Telephone | 205-410-8371
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Fax | 205-637-3378
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. BLAINE GUTHRIE BRINT
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Credential |
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Telephone | 205-410-8371
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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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