Montgomery County Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

023 Issued in AR

Legal business name

MONTGOMERY COUNTY ASSISTED LIVING

Practice address

741 South Drive
Mount Ida, AR 71957

Phone

(870) 867-2156

Fax

(870) 867-2049

NPI assigned

Jun 25, 2007

Last updated

Aug 22, 2020By 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

Mr. Bryan Fredrick Wann

Title

Administrator

Phone

(870) 867-2156

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255537486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1208",
            "city": "MOUNT IDA",
            "state": "AR",
            "postal_code": "719571208",
            "telephone_number": "870-867-2156",
            "fax_number": "870-867-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 SOUTH DRIVE",
            "city": "MOUNT IDA",
            "state": "AR",
            "postal_code": "71957",
            "telephone_number": "870-867-2156",
            "fax_number": "870-867-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY COUNTY ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANN",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "FREDRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "870-867-2156",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "AR",
            "license": "023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara J Hill, PA
• Stacie L Hipp, APRN
• David P Hochstedler, PT
• Billie S Jones, CF-SLP
• Joshua M Lindsey, MD
• Montgomery County Nursing Home
• Ouachita Regional Counseling & Mental Health Center, Inc. (Ouachita Behavioral Health and Wellness)
• Barbara E Page, DVM
• Kathleen Nichole Peters, OTR
• Marvin Louis Poole, M.D.

• Assisted Living Facility in Mount Ida, AR
• Providers in Mount Ida, 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 Aug 22, 2020; 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.