Basic Information
| Provider Information | |||||||||
| NPI: | 1194822585 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BAXTER COUNTY NURSING FACILITY, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | AUBURN HILLS NURSING AND REHABIITATION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 517 NORTH DIXON | ||||||||
| Address2: | PO BOX 506 | ||||||||
| City: | MELBOURNE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72556 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8703684050 | ||||||||
| FaxNumber: | 8703684054 | ||||||||
| Practice Location | |||||||||
| Address1: | 3545 HWY 5 N | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704256931 | ||||||||
| FaxNumber: | 8704252456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HARGIS | ||||||||
| AuthorizedOfficialFirstName: | BOBBY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRES | ||||||||
| AuthorizedOfficialTelephone: | 8703684040 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | AR | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.