The Waters of White Hall, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THE WATERS OF WHITE HALL, LLC

Practice address

9209 Dollarway Rd
White Hall, AR 71602-2616

Phone

(870) 247-0800

NPI assigned

Sep 20, 2018

Organization subpart

No

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

Authorized official

Name

Michael Blisko

Title

MBR

Phone

(708) 449-1900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1609350073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9209 DOLLARWAY RD",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022616",
            "telephone_number": "870-247-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9209 DOLLARWAY RD",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022616",
            "telephone_number": "870-247-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERS OF WHITE HALL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "BLISKO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MBR",
        "authorized_official_telephone_number": "708-449-1900"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in White Hall, AR
• Providers in White Hall, AR by specialty
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; 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.