Provider Demographics
NPI:1508813775
Name:CHENAL HEALTHCARE LLC
Entity Type:Organization
Organization Name:CHENAL HEALTHCARE LLC
Other - Org Name:CHENAL REHABILITATION AND HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:D
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-228-4848
Mailing Address - Street 1:3115 S BOWMAN RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4623
Mailing Address - Country:US
Mailing Address - Phone:501-228-4848
Mailing Address - Fax:501-224-5950
Practice Address - Street 1:3115 S BOWMAN RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-4623
Practice Address - Country:US
Practice Address - Phone:501-228-4848
Practice Address - Fax:501-224-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR763314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154020311Medicaid
045288Medicare Oscar/Certification