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Organization
MADISON RESIDENTIAL CARE FACILITY
Active
Organization
MADISON RESIDENTIAL CARE FACILITY
Active
Other names
Madison Health and Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SY NIKSEFAT (OWNER)
(501) 888-4080
Entity
Organization
Contact information
Practice address
2821 W DIXON RD, LITTLE ROCK, AR 72206-4256
(501) 888-4080
(501) 486-9119
Mailing address
2821 W DIXON RD, LITTLE ROCK, AR 72206-4256
(501) 888-4080
(501) 486-9119
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
041
AR
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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