Provider Demographics
NPI:1912393836
Name:HIGHTOWER AND SHEPARD GROUP LLC
Entity Type:Organization
Organization Name:HIGHTOWER AND SHEPARD GROUP LLC
Other - Org Name:DALTON'S PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:PARKER
Authorized Official - Last Name:HIGHTOWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-471-9797
Mailing Address - Street 1:217 LAKEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-8120
Mailing Address - Country:US
Mailing Address - Phone:479-471-9797
Mailing Address - Fax:479-471-7559
Practice Address - Street 1:520 W 2ND ST
Practice Address - Street 2:
Practice Address - City:WALDRON
Practice Address - State:AR
Practice Address - Zip Code:72958-7057
Practice Address - Country:US
Practice Address - Phone:479-637-0061
Practice Address - Fax:479-637-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR109310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility