NPIMap

Organization Active NPI

Van Buren Legacy LLC

  • Assisted Living Facility
  • Van Buren, AR
National Provider Identifier
1407320658
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
VAN BUREN LEGACY LLC
Practice address
1012 Fayetteville Rd
Van Buren, AR 72956-3471
Phone
(479) 474-7233
Fax
(479) 474-3444
NPI assigned
Jan 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Tiffany Perryman
Title
Executive Director
Phone
(479) 474-7233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary
Alzheimer Center (Dementia Center) 311500000X

Addresses

Primary practice location

1012 Fayetteville Rd
Van Buren, AR 72956-3471

Mailing address

1012 Fayetteville Rd
Van Buren, AR 72956-3471
Phone (479) 474-7233

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548028800000",
    "number": "1407320658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 FAYETTEVILLE RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729563471",
            "telephone_number": "479-474-7233",
            "fax_number": "479-474-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 FAYETTEVILLE RD",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729563471",
            "telephone_number": "479-474-7233",
            "fax_number": "479-474-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN BUREN LEGACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A",
        "authorized_official_last_name": "PERRYMAN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "479-474-7233",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Buren, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.