Three Rivers Nursing and Rehabilitation LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THREE RIVERS NURSING AND REHABILITATION LLC

Practice address

33904 Highway 63 E
Marked Tree, AR 72365-9521

Phone

(970) 358-2432

Fax

(870) 358-4582

NPI assigned

Mar 30, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bonnie Quibodeaux

Title

Cfo

Phone

(225) 769-7960

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Three Rivers Healthcare and Rehabilitation Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Arkansas Elder Outreach of Little Rock, Inc

  • Skilled Nursing Facility
  • Crowley, LA
  • NPI 1669559910

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1386140341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33904 HIGHWAY 63 E",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723659521",
            "telephone_number": "970-358-2432",
            "fax_number": "870-358-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33904 HIGHWAY 63 E",
            "city": "MARKED TREE",
            "state": "AR",
            "postal_code": "723659521",
            "telephone_number": "970-358-2432",
            "fax_number": "870-358-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS NURSING AND REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "QUIBODEAUX",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "225-769-7960"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225471311",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Healthcare and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Three Rivers Healthcare and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joe Roach
• Kimitaka Saito, MD
• Bianca Smith
• Southern Health and Wellness, Inc
• The Doctor'S Office of Marked Tree
• Three Rivers SNF Operations LLC

• All providers in Marked Tree, AR
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.