Diversicare Pinedale, LLC
Organization Active NPI Skilled Nursing Facility · Newport, AR
NPI 1922096593 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1922096593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 654 (AR)
- Legal business name
- DIVERSICARE PINEDALE, LLC
- Practice address
- 1311 N Pecan St
Newport, AR 72112-2816 - Phone
- (870) 523-9514
- Fax
- (870) 523-8198
- NPI assigned
- Oct 7, 2005
- Organization subpart
- No
Authorized official
- Name
- Raymond L. Tyler Jr.
- Title
- Executive Vice President and Coo
- Phone
- (615) 771-7575
Member of 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 654 | AR | Yes |
Addresses
Primary practice location
1311 N Pecan St
Newport, AR 72112-2816
Mailing address
1311 N Pecan St
Newport, AR 72112-2816
Phone (870) 523-9514
Other names
- Newport Healthcare and Rehabilitation Center
Other providers in Newport, AR
- Amber Davis
- Christopher Davis
- Mary Kathryn Davis
- Delta Medical Group Inc
- Nakyra Dicus
- Doctors Health Group, Inc
- Jennifer L Dorris
- Brandy Douglas
- Shelia Dove
- Kelly Drye
All providers in Newport, AR · Skilled Nursing Facility in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.