Northwest Regional Supportive Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

430 Issued in AR

Legal business name

NORTHWEST REGIONAL SUPPORTIVE LIVING LLC

Practice address

1400 Old Bergman Rd
Harrison, AR 72601-3078

Phone

(870) 204-5102

NPI assigned

Jun 27, 2017

Last updated

Jun 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Todd Parker Hightower

Title

Manager

Phone

(479) 471-9797

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498521600000",
    "number": "1700306107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2568",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726022568",
            "telephone_number": "870-204-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 OLD BERGMAN RD",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013078",
            "telephone_number": "870-204-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST REGIONAL SUPPORTIVE LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A",
        "authorized_official_last_name": "HIGHTOWER",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "PARKER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-471-9797"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Harrison, AR
• Providers in Harrison, AR by specialty
• Assisted Living Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.