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General NPI Number Information
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NPI Number | 1669101143
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Entity Type | Organization
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Legal Business Name | COURTYARD ARKADELPHIA HEALTHCARE LLC
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 2701 TWIN RIVERS DR
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City | ARKADELPHIA
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State | AR
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Zip | 71923-4211
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Country | US
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Telephone | 870-246-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 150 OBERLIN AVE N STE 6
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4535
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Country | US
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Telephone | 732-800-6005
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | DAVID J
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Credential |
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Telephone | 917-410-5283
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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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