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NPI Code Detail

MEDICARE: CHENAL HEALTHCARE LLC

MEDICARE: CHENAL HEALTHCARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility763AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508813775
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHENAL HEALTHCARE LLC
Provider Business Mailing Address
First Line : 3115 S BOWMAN RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-4623
Country : US
Telephone Number : 501-228-4848
Fax Number : 501-224-5950
Provider Business Practice Location Address
First Line : 3115 S BOWMAN RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-4623
Country : US
Telephone Number : 501-228-4848
Fax Number : 501-224-5950
Authorized Official
Title or Position : MANAGER
Name : ROSEANN D. OWENS
Credential :
Telephone Number : 501-228-4848
Provider Enumeration Date : 05/31/2006
Last Update Date : 05/17/2016

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