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General NPI Number Information
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NPI Number | 1194969915
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Entity Type | Organization
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Legal Business Name | THE WOODS OF MONTICELLO HEALTH AND REHABILITATION, LLC
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 1194 N CHESTER ST
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City | MONTICELLO
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State | AR
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Zip | 71655-4133
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Country | US
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Telephone | 870-367-6852
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Fax | 870-367-3910
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Provider Business Mailing Address
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Address Line | 1423 CLARKVIEW RD SUITE 500
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City | BALTIMORE
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State | MD
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Zip | 21209-2134
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Country | US
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Telephone | 410-427-2700
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Fax | 414-815-5558
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Authorized Official
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Title or Position | MANAGER
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Name | MR. BRIAN K. REYNOLDS
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Credential |
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Telephone | 410-513-8738
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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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