Basic Information
Provider Information
NPI: 1700850054
EntityType: 2
ReplacementNPI:  
OrganizationName: BRIARWOOD NURSING AND REHABILITATION CENTER INC
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Mailing Information
Address1: 415 ROGERS AVE
Address2:  
City: FORT SMITH
State: AR
PostalCode: 729011903
CountryCode: US
TelephoneNumber: 4797834672
FaxNumber: 4797832217
Practice Location
Address1: 516 S RODNEY PARHAM RD
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722054716
CountryCode: US
TelephoneNumber: 5012249000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/14/2006
LastUpdateDate: 04/16/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: MORTON
AuthorizedOfficialFirstName: MICHAEL
AuthorizedOfficialMiddleName: S.
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 4797834672
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
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NPICertificationDate: 04/16/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X793ARY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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