Crestpark Dewitt, Llc

LBN: Crestpark Dewitt, Llc
Crestpark Dewitt, Llc is an health care organization with primary practice located at 1325 Liberty Dr , De Witt AR 72042-3430. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Crestpark Dewitt, Llc can be contacted via phone (870) 946-3569, or through Dilks, Melisha via phone (870) 821-0144.

Contact Information

Primary practice address
1325 Liberty Dr De Witt AR 72042-3430
Phone: (870) 946-3569
Fax: (870) 946-0699
Website:
Map and Directions
Authorized official contact:
Name: Dilks, Melisha
Phone: (870) 821-0144

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 637 Arkansas

Profile Details

NPI number 1528213642
LBN Legal business name Crestpark Dewitt, Llc
DBA Doing business as
Authorized official Dilks, Melisha
Entity Organization
Organization subpart 1 No
Enumeration date Nov 18th, 2008
Last updated Nov 18th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528213642 NPPES
Arkansas Other 015177 BCBS PROVIDER NUMBER
Arkansas MEDICAID PENDING BCBS PROVIDER NUMBER

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