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NPI Code Detail

MEDICARE: HICKORY HEIGHTS HEALTH AND REHAB, LLC

MEDICARE: HICKORY HEIGHTS HEALTH AND REHAB, 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 Facility

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 : 1518396274
Entity Type Code : Organization
Provider Name (Legal Business Name) : HICKORY HEIGHTS HEALTH AND REHAB, LLC
Provider Business Mailing Address
First Line : 415 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72901-1903
Country : US
Telephone Number : 479-783-4672
Fax Number : 479-783-2217
Provider Business Practice Location Address
First Line : 3 CHENAL HEIGHTS DR
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72223-3910
Country : US
Telephone Number : 501-830-2273
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : MR. MICHAEL S. MORTON
Credential :
Telephone Number : 479-783-4672
Provider Enumeration Date : 11/04/2013
Last Update Date : 04/17/2020

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