Provider Demographics
NPI:1912084450
Name:MEADOWVIEW HEALTHCARE AND REHAB
Entity Type:Organization
Organization Name:MEADOWVIEW HEALTHCARE AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-738-2021
Mailing Address - Street 1:825 N GASKILL ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72740-8968
Mailing Address - Country:US
Mailing Address - Phone:479-738-2021
Mailing Address - Fax:479-738-1515
Practice Address - Street 1:825 N GASKILL ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-8968
Practice Address - Country:US
Practice Address - Phone:479-738-2021
Practice Address - Fax:479-738-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR098314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR10519OtherAR BCBS
AR10519OtherAR BCBS