Basic Information
| Provider Information | |||||||||
| NPI: | 1205824851 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CABOT NURSING AND REHABILITATION CENTER, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CABOT NURSING AND REHABILITATION CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 NORTHPORT DR | ||||||||
| Address2: | |||||||||
| City: | CABOT | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720236002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018436181 | ||||||||
| FaxNumber: | 5018436736 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 NORTHPORT DR | ||||||||
| Address2: | |||||||||
| City: | CABOT | ||||||||
| State: | AR | ||||||||
| PostalCode: | 720236002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018436181 | ||||||||
| FaxNumber: | 5018436736 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MARTIN | ||||||||
| AuthorizedOfficialFirstName: | SHEILA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5018436181 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 771 | AR | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.