Organization
NORTHPORT HEALTH SERVICES OF ARKANSAS, LLC
Active
Other names
Fayetteville Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP CODY LONG (CFO)
(205) 391-3600
Entity
Organization
Contact information
Practice address
3100 N OLD MO RD, FAYETTEVILLE, AR 72703-4415
(479) 521-4353
Mailing address
3100 N OLD MO RD, FAYETTEVILLE, AR 72703-4415
(479) 521-4353
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
592
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119590311
—
AR
Enumeration date
05/24/2006
Last updated
10/26/2020
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