Bentonville Assisted Living Services

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

180230794 Issued in AR

Legal business name

BENTONVILLE ASSISTED LIVING SERVICES

Practice address

3317 SE L St
Bentonville, AR 72712-3793

Phone

(479) 254-8759

Fax

(479) 254-9349

NPI assigned

Apr 12, 2010

Last updated

Apr 12, 2010By 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

Thomas C Oppenheim

Title

President

Phone

(479) 426-6510

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1164748463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N MAIN ST APT 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124830",
            "telephone_number": "479-273-7344",
            "fax_number": "479-464-7169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 SE L ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123793",
            "telephone_number": "479-254-8759",
            "fax_number": "479-254-9349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENTONVILLE ASSISTED LIVING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "OPPENHEIM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "479-426-6510"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "180230794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180230794",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bentonville Eye Care PLLC
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• Bentonville Pediatrics
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• Assisted Living Facility in Bentonville, AR
• Providers in Bentonville, 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 Apr 12, 2010; 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.