Provider Demographics
NPI:1386718633
Name:SUMMIT HEALTH & REHABILITATION, LLC
Entity type:Organization
Organization Name:SUMMIT HEALTH & REHABILITATION, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-694-3781
Mailing Address - Street 1:506 N. LONG AVE.
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:AR
Mailing Address - Zip Code:71861
Mailing Address - Country:US
Mailing Address - Phone:870-694-3781
Mailing Address - Fax:870-694-2084
Practice Address - Street 1:506 N. LONG AVE.
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:AR
Practice Address - Zip Code:71861
Practice Address - Country:US
Practice Address - Phone:870-694-3781
Practice Address - Fax:870-694-2084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR782314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR045411Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER