- Enrollment id
- O20131211001368
- Enrollment state
- AR
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1518396274
- Multiple npi flag
- N
- Ccn
- 045455
- Associate id
- 8325275696
- Organization name
- HICKORY HEIGHTS HEALTH AND REHAB LLC
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- HICKORY HEIGHTS HEALTH AND REHAB, LLC
- Affiliation entity name
- CENTRAL ARKANSAS NURSING CENTERS
- Affiliation entity id
- 129
- Address line 1
- #3 CHENAL HEIGHTS DRIVE
- City
- LITTLE ROCK
- State
- AR
- Zip code
- 722233910