Organization
CREEKSIDE HEALTH AND REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN K. REYNOLDS (MANAGER)
(410) 513-8738
Entity
Organization
Contact information
Practice address
620 N PANTHER AVE, YELLVILLE, AR 72687-9313
(870) 449-4201
Mailing address
1423 CLARKVIEW RD, SUITE 500, BALTIMORE, MD 21209-2134
(410) 427-2700
(414) 815-5558
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
193308311
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193308311
—
AR
Enumeration date
10/08/2012
Last updated
06/09/2015
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