Salco NC Inc
Organization Active NPI Skilled Nursing Facility · Bryant, AR
NPI 1962851568 · NPPES record last updated Aug 25, 2016
Key facts
- NPI
- 1962851568
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- SALCO NC INC
- Practice address
- 6907 Highway 5 N
Bryant, AR 72022-7902 - Phone
- (501) 213-0547
- Fax
- (501) 213-0553
- NPI assigned
- Jun 6, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- OVATION HEALTH SYSTEMS INC
Authorized official
- Name
- Anthony Brandon Adams
- Title
- President/Ceo
- Phone
- (501) 932-0050
Owners & managing parties with NPI records 1
-
Arpana Edala, MD
Facilities with the same owner 8
Affiliated clinicians 1
-
Arpana Edala, MD
Medicare Care Compare: Nursing home
- Listed as
- Evergreen Living Center at Stagecoach
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 22, 2014
- Medicare certification status
- Active
- Certified beds
- 116 · 97.1 residents per day on average
- Chain
- Anthony & Bryan Adams
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Skilled nursing facility certification: CCN 045457
- Legal name
- SALCO NC INC
- Doing business as
- EVERGREEN LIVING CENTER AT STAGECOACH
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 22, 2014
- Last certification
- Jan 31, 2025
- Beds
- 116
- Ownership / control type
- Corporation
- Multi-facility organization
- Reliance Healthcare
- Most recent change of ownership
- Jul 2, 2016
- Organization structure
- Corporation · Proprietary
- Incorporated
- Apr 15, 2016 in AR
- Enrollment address
- 6907 Highway 5 North
Bryant, AR 72022-7902 - Nursing home name
- EVERGREEN LIVING CENTER AT STAGECOACH
- Affiliated entity
- ANTHONY & BRYAN ADAMS
All disclosed owners & managing parties 23
| Name | Role | Since | Share |
|---|---|---|---|
| Bryan Milburn Adams |
5% Or Greater Indirect Ownership Interest |
Jul 2, 2016 | 50% |
| Corporate Officer |
Jul 2, 2016 | 50% | |
| Arpana Edala |
Operational/Managerial Control |
Aug 28, 2024 | |
| Adp of the SNF | Aug 28, 2024 | ||
| Kimberly R Schaap |
Adp of the SNF | Jul 2, 2016 | |
| RHS Nursing, LLC |
Adp of the SNF | Jul 2, 2016 | |
| LTC Systems/RX, LLC |
Adp of the SNF | Jul 2, 2016 | |
| Larry M McGinnis |
Adp of the SNF | Jul 2, 2016 | |
| Pharmacy Consults, LLC |
Adp of the SNF | Jul 2, 2016 | |
| M&M Hathorn, LLC |
Adp of the SNF | Jul 2, 2016 | |
| Incite Rehab, LLC |
Adp of the SNF | Jul 2, 2016 | |
| Toni Hanna |
Managing Control - Governing Body |
Aug 28, 2024 | |
| Adp of the SNF | Aug 28, 2024 | ||
| Ovation Health Systems, Inc |
5% Or Greater Direct Ownership Interest | Apr 25, 2016 | 100% |
| Rita Pedigo |
Adp of the SNF | Jul 2, 2016 | |
| H & S Bryant, LLC |
Adp of the SNF | Jul 2, 2016 | |
| William Mainord |
Adp of the SNF | Jul 2, 2016 | |
| John Ellis |
Corporate Officer |
Jul 2, 2016 | |
| Adp of the SNF | Nov 26, 2024 | ||
| Reliance Health Care, Inc. |
Adp of the SNF | Jul 2, 2016 | |
| Stephen McGuire |
Corporate Director |
Jul 2, 2016 | |
| Managing Control - Governing Body |
Jul 2, 2016 | ||
| Adp of the SNF | Jul 2, 2016 | ||
| Amanda Roeck |
Operational/Managerial Control | Nov 25, 2024 | |
| Managing Control - Governing Body |
Nov 26, 2024 | ||
| Adp of the SNF | Nov 26, 2024 | ||
| Tobey Koehler |
Corporate Officer |
Dec 20, 2007 | |
| Adp of the SNF | Jul 2, 2016 | ||
| Anthony Brandon Adams |
5% Or Greater Indirect Ownership Interest |
Jul 2, 2016 | 50% |
| Corporate Officer |
Jul 2, 2016 | 50% | |
| Don Schaap |
Adp of the SNF | Jul 2, 2016 | |
| Michael Hathorn |
Adp of the SNF | Jul 2, 2016 | |
| Schaap, LLC |
Adp of the SNF | Jul 2, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160714001223 | AR | Part a Provider - Skilled Nursing Facility | 7517259351 | Practice locations: Bryant, AR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
6907 Highway 5 N
Bryant, AR 72022-7902
Mailing address
6907 Highway 5 N
Bryant, AR 72022-7902
Phone (501) 213-0547
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 214133311 | Medicaid | AR | |
| 1117 | Other | AR | FACILITY LICENSE |
Other names
- EVERGREEN LIVING CENTER AT STAGECOACH
Other providers in Bryant, AR
- Rebecca J Rusnak
- Heather Leigh Russell
- Madison Russell
- Rebecca Danielle Russell
- Catherine Hope Salazar
- Saline Dental Group
- Saline Hospital LLC
- Saline Hospital LLC
- Saline Physician Services, LLC
- Saline Physician Services, LLC
All providers in Bryant, 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 25, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.