Basic Information
| Provider Information | |||||||||
| NPI: | 1164837159 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WHITE HALL HEALTH & REHAB, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1423 CLARKVIEW RD | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212092134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104272678 | ||||||||
| FaxNumber: | 4148155558 | ||||||||
| Practice Location | |||||||||
| Address1: | 9209 DOLLARWAY RD | ||||||||
| Address2: | |||||||||
| City: | WHITE HALL | ||||||||
| State: | AR | ||||||||
| PostalCode: | 716022616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702470800 | ||||||||
| FaxNumber: | 8702470802 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2014 | ||||||||
| LastUpdateDate: | 06/27/2014 | ||||||||
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| AuthorizedOfficialLastName: | BAIRD | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4104272678 | ||||||||
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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.