Provider Demographics
NPI:1326582214
Name:SPRING PLACE HEALTHCARE & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:SPRING PLACE HEALTHCARE & REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-635-1195
Mailing Address - Street 1:200 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:HAZEN
Mailing Address - State:AR
Mailing Address - Zip Code:72064-8306
Mailing Address - Country:US
Mailing Address - Phone:870-225-7515
Mailing Address - Fax:870-255-4910
Practice Address - Street 1:200 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:HAZEN
Practice Address - State:AR
Practice Address - Zip Code:72064-8306
Practice Address - Country:US
Practice Address - Phone:870-225-7515
Practice Address - Fax:870-255-4910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
045228Medicare Oscar/Certification