SOUTH BRIDGE, LLC (NPI# 1568640589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568640589 |
| Entity Type | Organization |
| Organization Name | SOUTH BRIDGE, LLC |
| Other Organization Name | RETIREMENT CENTER OF MORRILTON |
| Practice Address |
1209 S Bridge St Morrilton AR 72110-4614 |
| Mailing Address |
Po Box 56678 Little Rock AR 72215-6678 |
| Practice Telephone | 5013545003 |
| Practice Fax Number | 5013541399 |
| Mailing Telephone | 5012244173 |
| Mailing Fax Number | 5012170445 |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |
| Authorized Official Name | MR. EDWARD V HOLMAN (OWNER) |
| Authorized Official Telephone | 5012244173 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Retirement Center of Morrilton | Doing Business As Name - Organization |
| Street Address |
1209 S BRIDGE ST |
| City | MORRILTON |
| State | AR |
| Zip Code | 72110-4614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326692674 | Kaitlyn Riggin | Counselor | 100 S. Cherokee, Morrilton, AR 72110 | 2019-07-25 |
| 1871976530 | Zachary Dixon Family Dental/ Dixon Family Dental | Dentist | 1700 University Blvd, Suite 105, Morrilton, AR 72110 | 2015-06-30 |
| 1669854493 | Stuart Sherwood | Dentist | 1700 University Blvd., Suite 105, Morrilton, AR 72110 | 2015-06-29 |
| 1538392360 | Sandra L Greeson | Physical Therapist | 27 Cothren Estates, Morrilton, AR 72110 | 2009-08-27 |
| 1295998128 | Brenda J Alred | Speech-Language Pathologist | 100 Robert Fiser Drive, Morrilton, AR 72110 | 2008-07-10 |
| 1043417835 | Three Guys, Inc | Pharmacy | 100 South Joseph St, Morrilton, AR 72110 | 2007-06-27 |
| 1720100464 | Brenda Wilson | Physical Therapist | 100 Robert H. Fiser Dr., Morrilton, AR 72110 | 2007-04-04 |
| 1770631467 | Conway County Community Service Inc. | Community/Behavioral Health | 100 S Cherokee St., Morrilton, AR 72110 | 2007-01-08 |
| 1154489581 | Jackie Coombe-moore | Psychiatry & Neurology | Counseling Associates, Inc, 8 Hospital Drive, Morrilton, AR 72110 | 2006-12-05 |
| 1932275195 | University of Arkansas for Medical Sciences | Pediatrics | 100 Robert Fiser Ave, Morrilton, AR 72110 | 2006-11-28 |
| Find all providers in zip 72110 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538373931 | Delta House | Intermediate Care Facility, Mental Illness | 252 Desota, West Helena, AR 72390-2823 | 2007-05-09 |
| 1518170612 | Retirement Centers of Arkansas | Intermediate Care Facility, Mental Illness | 8900 Highway 107, Sherwood, AR 72120-2932 | 2007-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.