LTC of Eureka Springs, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LTC OF EUREKA SPRINGS, LLC

Practice address

235 Huntsville Rd
Eureka Springs, AR 72632-9572

Phone

(479) 253-7038

NPI assigned

Sep 7, 2018

Organization subpart

No

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

Authorized official

Name

Mathias Dasal

Title

Manager

Phone

(573) 746-7100

Specialties & licenses 1

Addresses

Other names 1

• Brighton Ridge Doing business as

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1912480880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 OSAGE BEACH PKWY",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650652179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 HUNTSVILLE RD",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "726329572",
            "telephone_number": "479-253-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC OF EUREKA SPRINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A",
        "authorized_official_last_name": "DASAL",
        "authorized_official_first_name": "MATHIAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-746-7100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brighton Ridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brighton Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Eureka Springs, AR
• Skilled Nursing Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.