Organization
HERITAGE SQUARE NURSING AND REHABILITATION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
A BRANDON ADAMS (PRESIDENT)
(501) 932-0050
Entity
Organization
Contact information
Practice address
710 N RUDDLE RD, BLYTHEVILLE, AR 72315-2137
(870) 763-3654
(870) 762-1172
Mailing address
710 N RUDDLE RD, BLYTHEVILLE, AR 72315-2137
(870) 763-3654
(870) 762-1172
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
672
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119680311
—
AR
Enumeration date
09/22/2005
Last updated
06/30/2016
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