Provider Demographics
NPI:1942544606
Name:SRCNC INC
Entity Type:Organization
Organization Name:SRCNC INC
Other - Org Name:THE CROSSING AT RIVERSIDE HEALTH AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
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 1:2500 E MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4750
Mailing Address - Country:US
Mailing Address - Phone:501-268-2324
Mailing Address - Fax:501-268-0428
Practice Address - Street 1:2500 E MOORE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4750
Practice Address - Country:US
Practice Address - Phone:501-268-2324
Practice Address - Fax:501-268-0428
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OVATION HEALTH SYSTEMS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-19
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR993314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR195065311Medicaid
AR045209Medicare Oscar/Certification