South Bridge, LLC

Primary specialty

Mental Illness Intermediate Care FacilityTaxonomy code 310500000X

Legal business name

SOUTH BRIDGE, LLC

Doing business as

Retirement Center of Morrilton

Practice address

1209 S Bridge St
Morrilton, AR 72110-4614

Phone

(501) 354-5003

Fax

(501) 354-1399

NPI assigned

Jan 31, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Edward V Holman

Title

Owner

Phone

(501) 224-4173

Specialties & licenses 1

Addresses

Other names 1

• Retirement Center of Morrilton Doing business as

Locations

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201737600000",
    "number": "1568640589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 56678",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722156678",
            "telephone_number": "501-224-4173",
            "fax_number": "501-217-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 S BRIDGE ST",
            "city": "MORRILTON",
            "state": "AR",
            "postal_code": "721104614",
            "telephone_number": "501-354-5003",
            "fax_number": "501-354-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BRIDGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-01-31",
        "status": "A",
        "authorized_official_last_name": "HOLMAN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-224-4173",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Retirement Center of Morrilton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stuart Sherwood, DDS
• Heather Elizabeth Simpson, MHPP
• Alexis Michelle Smith
• Danica Leanna Smith, MHPP
• Linda M. Smith, RNBC
• South Conway County School
• Kenneth Harold Sowers, D.C.
• Rhonda Denise Spaul, MHPP
• St Anthony'S Hospital Association
• St Vincent Infirmary Medical Center

• Mental Illness Intermediate Care Facility in Morrilton, AR
• Providers in Morrilton, AR by specialty
• Mental Illness Intermediate Care Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; 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.