Diversicare Leasing Corp.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

531 Issued in AR

Legal business name

DIVERSICARE LEASING CORP.

Practice address

66 Ozbirn LN
Ash Flat, AR 72513-9522

Phone

(870) 994-2341

Fax

(870) 994-2344

NPI assigned

Oct 7, 2005

Organization subpart

No

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

Authorized official

Name

Raymond L. Tyler Jr.

Title

Executive Vice President and Coo

Phone

(615) 771-7575

Specialties & licenses 1

Addresses

Other names 1

• Ash Flat Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760470330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 OZBIRN LN",
            "city": "ASH FLAT",
            "state": "AR",
            "postal_code": "725139522",
            "telephone_number": "870-994-2341",
            "fax_number": "870-994-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 OZBIRN LN",
            "city": "ASH FLAT",
            "state": "AR",
            "postal_code": "725139522",
            "telephone_number": "870-994-2341",
            "fax_number": "870-994-2344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSICARE LEASING CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT AND COO",
        "authorized_official_telephone_number": "615-771-7575",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "AR",
            "license": "531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ash Flat Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mathew Britton Currie, MHPP
• Crystal Cuypers, RECOVERY ASSISTANT
• Harlee Mae Deloach
• Kayla Deloach, RECOVERY ASSISTANT
• Jeremiah Daniel Dillehay, LPC
• Doncheff Chiropractic Clinic
• Anthony Iwan Doncheff, D.C.
• Shasta Dorris, CMP
• Sheila Doughtery, CMP
• Catherine Duncan, RECOVERY ASSISTANT

• All providers in Ash Flat, AR
• Skilled Nursing 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.