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NPI Code Detail

MEDICARE: HIGHLANDS OF HEBER SPRINGS, LLC

MEDICARE: HIGHLANDS OF HEBER SPRINGS, 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

General Provider Information

NPI Number : 1871911974
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLANDS OF HEBER SPRINGS, LLC
Provider Business Mailing Address
First Line : 2 OFFICE PARK CIR
Second Line : SUITE 110
City : MOUNTAIN BRK
State : AL
Zip : 35223-2509
Country : US
Telephone Number : 205-410-8371
Fax Number : 205-637-3378
Provider Business Practice Location Address
First Line : 1040 WEDDING FORD RD
Second Line :
City : HEBER SPRINGS
State : AR
Zip : 72543-1914
Country : US
Telephone Number : 501-362-8137
Fax Number : 501-362-8960
Authorized Official
Title or Position : SECRETARY
Name : MR. BLAINE GUTHRIE BRINT
Credential :
Telephone Number : 205-410-8371
Provider Enumeration Date : 04/04/2014
Last Update Date : 10/21/2015

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