Provider Demographics
NPI:1679658637
Name:WHITE RIVER HEALTH SYSTEM
Entity Type:Organization
Organization Name:WHITE RIVER HEALTH SYSTEM
Other - Org Name:SEARCY COUNTY NURSING AND REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE ADMINISTRATOR - LTC DIVIS
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:D
Authorized Official - Last Name:JARVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:870-670-5690
Mailing Address - Street 1:PO BOX 541
Mailing Address - Street 2:#1 CEDAR ST
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-0541
Mailing Address - Country:US
Mailing Address - Phone:870-448-3577
Mailing Address - Fax:870-448-4884
Practice Address - Street 1:100 SOUTH CEDAR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:AR
Practice Address - Zip Code:72650
Practice Address - Country:US
Practice Address - Phone:870-448-3577
Practice Address - Fax:870-448-4884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR624314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR045353Medicare ID - Type Unspecified