NPIMap

Organization Active NPI

Living Hope Southwest Medical Services, LLC

Doing business as Living Hope Texarkana

  • Psychiatric Hospital
  • Texarkana, AR
National Provider Identifier
1669428785
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
AR3925 Issued in AR
Legal business name
LIVING HOPE SOUTHWEST MEDICAL SERVICES, LLC
Doing business as
Living Hope Texarkana
Practice address
801 Arkansas Blvd
Texarkana, AR 71854-2107
Phone
(870) 774-4673
Fax
(870) 774-9313
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kimbro Stephens
Title
President
Phone
(870) 774-4673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X AR3925 AR Primary

Addresses

Primary practice location

801 Arkansas Blvd
Texarkana, AR 71854-2107

Mailing address

801 Arkansas Blvd
Texarkana, AR 71854-2107
Phone (870) 774-4673

Other identifiers 2

IdentifierTypeStateIssuer
AR3925OtherARHOSPITAL LICENSE
H04533P49MedicaidTX

Other names 1

  • Living Hope Texarkana Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Hospital certification: CCN 044016

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LIVING HOPE SOUTHWEST MEDICAL SERVICES LLC
Certification status
Terminated Voluntary: merger or closure, Jul 18, 2008
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 31, 1998
Last certification
Feb 13, 2008
Beds
62
Ownership / control type
Private (not for profit)
Facility address
801 Arkansas Blvd
Texarkana, AR 71854

National Provider Directory

National Provider Directory
Tax ID family
Living Hope Southwest Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669428785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542107",
            "telephone_number": "870-774-4673",
            "fax_number": "870-774-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 ARKANSAS BLVD",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718542107",
            "telephone_number": "870-774-4673",
            "fax_number": "870-774-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING HOPE SOUTHWEST MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "KIMBRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-774-4673",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "AR",
            "license": "AR3925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPITAL LICENSE",
            "identifier": "AR3925",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H04533P49",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Living Hope Texarkana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Texarkana, AR

Sources for this page

Verify at the official NPI Registry.