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General NPI Number Information
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NPI Number | 1346630589
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Entity Type | Organization
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Legal Business Name | CHG HOSPITAL LITTLE ROCK, LLC
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 2 SAINT VINCENT CIR 6TH FLOOR
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5423
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Country | US
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Telephone | 501-265-0600
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Fax | 501-265-0638
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Provider Business Mailing Address
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Address Line | 680 SOUTH FOURTH STREET LICENSE AND CERTIFICATION
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City | LOUSIVILLE
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State | KY
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Zip | 40202-2708
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Country | US
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Telephone | 25-966-0635
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Fax | 502-212-8481
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Authorized Official
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Title or Position | DIR, LICENSURE AND CERTIFICATION
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Name | JOHNETTA TRAYLOR
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Credential |
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Telephone | 502-596-6063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number |
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License Number State |
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