Blankenship Management Co.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

044 Issued in AR

Legal business name

BLANKENSHIP MANAGEMENT CO.

Doing business as

Southridge Village of Conway

Practice address

1306 S Donaghey Ave
Conway, AR 72034-6711

Phone

(501) 327-3030

Fax

(501) 327-3034

NPI assigned

Dec 2, 2009

Last updated

Dec 2, 2009By 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

Ms. Ashley M Blankenship

Title

Administrator

Phone

(501) 327-3030

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southridge Village of Conway Doing business as

Locations

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1245568260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 S DONAGHEY AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346711",
            "telephone_number": "501-327-3030",
            "fax_number": "501-327-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 S DONAGHEY AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346711",
            "telephone_number": "501-327-3030",
            "fax_number": "501-327-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANKENSHIP MANAGEMENT CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-02",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "BLANKENSHIP",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-327-3030",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179489794",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southridge Village of Conway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wendy J Blackwood, MS, LAC, NCC
• Karli Blair
• Cameria Blake, MHPP
• Kimberly Lorene Blake, FNP-C
• Aimee M Blalock
• Heather Yvonne Blankenship, R.D.A
• Amanda Rae Bledsoe, D.C.
• Jamie Block, LAC
• Alexandria E Blouin
• Lorenzo L Boatman, RECOVERY ASSISTANT

• Assisted Living Facility in Conway, AR
• Providers in Conway, 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 Dec 2, 2009; 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.