Provider Demographics
NPI:1710759931
Name:SALINE HEART REHAB AND DIETARY SRVICES
Entity Type:Organization
Organization Name:SALINE HEART REHAB AND DIETARY SRVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-315-4008
Mailing Address - Street 1:PO BOX 2860
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72018-2860
Mailing Address - Country:US
Mailing Address - Phone:501-315-4008
Mailing Address - Fax:501-315-3411
Practice Address - Street 1:1000 HWY 35 N STE 9
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-2353
Practice Address - Country:US
Practice Address - Phone:501-315-4008
Practice Address - Fax:501-315-3411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SALINE HEART REHAB AND DIETARY SRVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-23
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac RehabilitationGroup - Multi-Specialty
No261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac FacilitiesGroup - Multi-Specialty