Basic Information
| Provider Information | |||||||||
| NPI: | 1770805459 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAMESTOWN HEALTH AND REHAB LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | JAMESTOWN HEALTH AND REHAB | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 299 S 24TH ST | ||||||||
| Address2: | |||||||||
| City: | ROGERS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727581102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4796365497 | ||||||||
| FaxNumber: | 4796219095 | ||||||||
| Practice Location | |||||||||
| Address1: | 2001 S HAMPTON PL | ||||||||
| Address2: | |||||||||
| City: | ROGERS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727581352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4799868431 | ||||||||
| FaxNumber: | 4796361184 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2010 | ||||||||
| LastUpdateDate: | 02/22/2010 | ||||||||
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| AuthorizedOfficialLastName: | NORSWORTHY | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CHEIF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 4796365497 | ||||||||
| IsSoleProprietor: | |||||||||
| 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.