Provider Demographics
NPI:1851387187
Name:NORTHWEST HEALTH AND REHAB, INC.
Entity Type:Organization
Organization Name:NORTHWEST HEALTH AND REHAB, INC.
Other - Org Name:NORTH HILLS LIFE CARE AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:A
Authorized Official - Middle Name:BRANDON
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-932-0050
Mailing Address - Street 1:27 E APPLEBY RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3902
Mailing Address - Country:US
Mailing Address - Phone:479-444-9000
Mailing Address - Fax:479-444-9090
Practice Address - Street 1:27 E APPLEBY RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3902
Practice Address - Country:US
Practice Address - Phone:479-444-9000
Practice Address - Fax:479-444-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-22
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR754314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154011311Medicaid
AR154011311Medicaid