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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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