Organization
NORTHRIDGE HC&R NURSING LLC
Active
Other names
Northridge Healthcare and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
BOYD P GENTRY (PRESIDENT & CEO)
(937) 964-8974
Entity
Organization
Contact information
Practice address
2501 JOHN ASHLEY DR, NORTH LITTLE ROCK, AR 72114-1815
(501) 758-3800
(501) 758-2276
Mailing address
2501 JOHN ASHLEY DR, NORTH LITTLE ROCK, AR 72114-1815
(501) 758-3800
(501) 758-2276
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191373311
—
AR
Enumeration date
02/21/2012
Last updated
05/07/2012
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