Provider Demographics
NPI:1316162852
Name:HOT SPRINGS REHABILITATION CENTER HOSPITAL
Entity type:Organization
Organization Name:HOT SPRINGS REHABILITATION CENTER HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:RUTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-624-4411
Mailing Address - Street 1:105 RESERVE ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS NATIONAL PARK
Mailing Address - State:AR
Mailing Address - Zip Code:71901-4195
Mailing Address - Country:US
Mailing Address - Phone:501-624-4411
Mailing Address - Fax:501-624-0019
Practice Address - Street 1:105 RESERVE ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-4195
Practice Address - Country:US
Practice Address - Phone:501-624-4411
Practice Address - Fax:501-624-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARIP00090283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR162835407Medicaid