Provider Demographics
NPI:1437290160
Name:BASS HEALTHCARE ENTERPRISES LLC
Entity type:Organization
Organization Name:BASS HEALTHCARE ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:W
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-875-5447
Mailing Address - Street 1:521 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956-5109
Mailing Address - Country:US
Mailing Address - Phone:479-410-1740
Mailing Address - Fax:479-410-1596
Practice Address - Street 1:900 W RANCHWOOD DR
Practice Address - Street 2:
Practice Address - City:WILBURTON
Practice Address - State:OK
Practice Address - Zip Code:74578-3630
Practice Address - Country:US
Practice Address - Phone:918-465-2314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility