Basic Information
| Provider Information | |||||||||
| NPI: | 1679717490 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | APPLE RIDGE HEALTH AND REHABILITATION, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1423 CLARKVIEW RD | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212092134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4104272700 | ||||||||
| FaxNumber: | 4148155558 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 ORENDORFF AVE | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726014634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707413438 | ||||||||
| FaxNumber: | 8707419117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2009 | ||||||||
| LastUpdateDate: | 06/09/2015 | ||||||||
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| AuthorizedOfficialLastName: | REYNOLDS | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | K. | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4105138738 | ||||||||
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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.