Provider Demographics
NPI:1801286471
Name:HIGHLANDS OF STAMPS, LLC
Entity type:Organization
Organization Name:HIGHLANDS OF STAMPS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BLAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-410-8371
Mailing Address - Street 1:826 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:STAMPS
Mailing Address - State:AR
Mailing Address - Zip Code:71860-4522
Mailing Address - Country:US
Mailing Address - Phone:870-533-4444
Mailing Address - Fax:870-533-8841
Practice Address - Street 1:826 NORTH ST
Practice Address - Street 2:
Practice Address - City:STAMPS
Practice Address - State:AR
Practice Address - Zip Code:71860-4522
Practice Address - Country:US
Practice Address - Phone:870-533-4444
Practice Address - Fax:870-533-8841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
045232Medicare Oscar/Certification