Provider Demographics
NPI:1164837159
Name:WHITE HALL HEALTH & REHAB, LLC
Entity Type:Organization
Organization Name:WHITE HALL HEALTH & REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-427-2678
Mailing Address - Street 1:1423 CLARKVIEW RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2134
Mailing Address - Country:US
Mailing Address - Phone:410-427-2678
Mailing Address - Fax:414-815-5558
Practice Address - Street 1:9209 DOLLARWAY RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-2616
Practice Address - Country:US
Practice Address - Phone:870-247-0800
Practice Address - Fax:870-247-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR045372Medicare Oscar/Certification