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General NPI Number Information
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NPI Number | 1699920637
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Entity Type | Organization
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Legal Business Name | CRESTPARK RETIREMENT HELENA, LLC
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 110 HOSPITAL DR
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City | HELENA
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State | AR
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Zip | 72342-1507
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Country | US
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Telephone | 870-338-3405
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Fax | 870-338-3499
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Provider Business Mailing Address
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Address Line | PO BOX 310
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City | HELENA
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State | AR
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Zip | 72342-0310
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Country | US
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Telephone | 870-338-3405
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Fax | 870-338-3499
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. BARBARA BELEW
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Credential |
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Telephone | 501-626-7986
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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 | 639
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License Number State | AR
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