Organization
SRN MANAGEMENT, LLC
Active
Other names
Cottage Lane Health and Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ANDREW RYE (VICE PRESIDENT)
(479) 410-1740
Entity
Organization
Contact information
Practice address
800 BROOKSIDE DR, LITTLE ROCK, AR 72205-1644
(501) 224-3940
(501) 224-6649
Mailing address
8520 S 36TH TER, FORT SMITH, AR 72908-8880
(479) 410-1740
(479) 410-1596
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1059
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208289311
—
AR
Enumeration date
06/05/2015
Last updated
10/18/2016
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