Organization
STONERIDGE HEALTH AND REHAB CENTER
Active
Other names
StoneRidge Health & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURT L LUTH (REGISTERED AGENT)
(501) 833-5627
Entity
Organization
Contact information
Practice address
4017 FRANKLIN, COLLEGE STATION, AR 72053
(501) 490-1533
(501) 490-0608
Mailing address
1051 LANTRIP RD, SHERWOOD, AR 72120-4161
(501) 833-5627
(501) 835-6905
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
0798
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162852311
—
AR
Enumeration date
01/10/2007
Last updated
12/09/2014
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