Basic Information
| Provider Information | |||||||||
| NPI: | 1093188401 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILLOW POINTE HEALTH & REHAB CENTER | ||||||||
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| OtherOrganizationName: | WILLOW POINTE HEALTH & REHAB CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1051 LANTRIP RD | ||||||||
| Address2: | |||||||||
| City: | SHERWOOD | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721204161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018335627 | ||||||||
| FaxNumber: | 5018330166 | ||||||||
| Practice Location | |||||||||
| Address1: | 1010 BARNES ST | ||||||||
| Address2: | |||||||||
| City: | LONOKE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720862003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016763103 | ||||||||
| FaxNumber: | 5016767730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2015 | ||||||||
| LastUpdateDate: | 11/06/2015 | ||||||||
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| AuthorizedOfficialLastName: | LUTH | ||||||||
| AuthorizedOfficialFirstName: | KURT | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5018335627 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.