Organization
MOUNTAINCREST REHAB SERVICES
Active
Other names
Mountaincrest Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL DAMARILLO SEBAG RPT (EXECUTIVE DIRECTOR)
(870) 743-5573
Entity
Organization
Contact information
Practice address
816 N MAIN ST, HARRISON, AR 72601-2915
(870) 743-5573
(870) 743-5974
Mailing address
PO BOX 841, HARRISON, AR 72602-0841
(870) 743-5573
(870) 743-5974
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5C311
BLUE CROSS BLUE SHIELD
AR
Enumeration date
12/07/2005
Last updated
11/29/2007
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