Basic Information
| Provider Information | |||||||||
| NPI: | 1659527844 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LINDLEY HEALTH & REHAB CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 326 LINDLEY LN | ||||||||
| Address2: | |||||||||
| City: | NEWPORT | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721124948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705236539 | ||||||||
| FaxNumber: | 8705238561 | ||||||||
| Practice Location | |||||||||
| Address1: | 326 LINDLEY LN | ||||||||
| Address2: | |||||||||
| City: | NEWPORT | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721124948 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705236539 | ||||||||
| FaxNumber: | 8705238561 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2008 | ||||||||
| LastUpdateDate: | 08/07/2008 | ||||||||
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| AuthorizedOfficialLastName: | AUSTIN | ||||||||
| AuthorizedOfficialFirstName: | JENNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8705236539 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 863 | AR | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 168534311 | 05 | AR | MEDICAID |