Provider Demographics
NPI:1396433116
Name:STROUD NURSING & REHAB LLC
Entity type:Organization
Organization Name:STROUD NURSING & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-715-6759
Mailing Address - Street 1:5305 W VILLAGE PKWY STE 9
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8116
Mailing Address - Country:US
Mailing Address - Phone:479-715-6759
Mailing Address - Fax:
Practice Address - Street 1:721 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:STROUD
Practice Address - State:OK
Practice Address - Zip Code:74079-4500
Practice Address - Country:US
Practice Address - Phone:918-968-2075
Practice Address - Fax:918-968-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility