EVERGREENE PROPERTIES OF NORTH CAROLINA,LLC (NPI# 1518976513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518976513 |
| Entity Type | Organization |
| Organization Name | EVERGREENE PROPERTIES OF NORTH CAROLINA,LLC |
| Other Organization Name | CRESTPARK INN OF FORREST CITY |
| Practice Address |
603 Kittle Road Forrest City AR 72335-1033 |
| Mailing Address |
Po Box 1033 Forrest City AR 72336-1033 |
| Practice Telephone | 8706337630 |
| Practice Fax Number | 8706336863 |
| Mailing Telephone | 8706337630 |
| Mailing Fax Number | 8706336863 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DANIEL C GREENE (MANAGER) |
| Authorized Official Telephone | 3366683896 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 632 | AR | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| CRESTPARK INN OF FORREST CITY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992714992 | Evergreene Properties of North Carolina,llc | Skilled Nursing Facility | 1325 Liberty Drive, Dewitt, AR 72042-0589 | 2006-08-07 |
| 1326057613 | Evergreene Properties of North Carolina,llc | Skilled Nursing Facility | 116 November, Helena, AR 72342-1502 | 2006-08-05 |
| 1265441653 | Evergreene Properties of North Carolina,llc | Skilled Nursing Facility | 707 W 20th St, Stuttgart, AR 72160-6500 | 2006-08-05 |
| 1457361974 | Evergreene Properties of North Carolina,llc | Skilled Nursing Facility | 110 Hospital Dr, Helena, AR 72342-1507 | 2006-08-08 |
| Street Address |
603 KITTLE ROAD |
| City | FORREST CITY |
| State | AR |
| Zip Code | 72335-1033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740335546 | Charles Marrs | Physical Therapy Assistant | 603 Kittle Road, Forrest City, AR 72335 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285112888 | Briana Lanay Hatcher | Specialist/Technologist | 801 Deadrick Rd., Forrest City, AR 72335 | 2018-08-06 |
| 1922545383 | Kimberly Burnett | Speech-Language Pathologist | 400 Dawson Rd., Forrest City, AR 72335 | 2017-01-24 |
| 1134510951 | Kaylee Marple | Occupational Therapy Assistant | 726 North Washington St, Forrest City, AR 72335 | 2015-02-16 |
| 1033534185 | My Ride Transportation 2, LLC. | Non-emergency Medical Transport (VAN) | 224 Bond Dr., Forrest City, AR 72335 | 2014-02-26 |
| 1457796187 | Katherine Elizabeth Ramsey | Occupational Therapy Assistant | 3326 Highway 1 South, Forrest City, AR 72335 | 2013-05-08 |
| 1902158785 | Brittany Nicole Mitchell | Speech-Language Pathologist | 149 Water St., Lincoln Middle School, Forrest City, AR 72335 | 2012-10-04 |
| 1114278058 | Ashley Danielle Busby | Speech-Language Pathologist | 801 Deadrick Road, Forrest City, AR 72335 | 2012-10-01 |
| 1548569585 | East Arkansas Physical Therapy | Clinic/Center | 3150 N Washington, Forrest City, AR 72335 | 2011-03-16 |
| 1487801007 | David George Boyles | Psychologist | 3998 Highway 1 North, Forrest City, AR 72335 | 2008-08-26 |
| 1255515581 | Shontel Denise Wilson | Speech-Language Pathologist | 300 Eldridge Rd, Suite 1, Forrest City, AR 72335 | 2007-12-21 |
| Find all providers in zip 72335 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023026135 | Evergreene Properties of North Carolina, LLC | Skilled Nursing Facility | 500 Kittle Rd, Forrest City, AR 72335-2417 | 2006-08-04 |
| 1417102468 | Crestpark Forrest City, LLC | Skilled Nursing Facility | 500 Kittle Rd, Forrest City, AR 72335-2417 | 2008-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558904979 | Ola Ops, Inc. | Skilled Nursing Facility | 502 W Pennington St, Ola, AR 72853-8851 | 2019-10-18 |
| 1831746676 | Cwnc Ops Inc | Skilled Nursing Facility | 1393 E Don Tyson Pkwy, Springdale, AR 72764-7882 | 2019-08-26 |
| 1881256493 | Bayshore, LLC | Skilled Nursing Facility | 260 Lakepark Dr, Hot Springs, AR 71901-9260 | 2019-07-03 |
| 1508322249 | Superior Health & Rehab LLC | Skilled Nursing Facility | 625 Tommy Lewis Dr, Conway, AR 72032-7006 | 2019-02-19 |
| 1447733480 | Chc Lakeside Nursing Center, LLC | Skilled Nursing Facility | 1207 Willow Run St, Lake City, AR 72437-9520 | 2018-09-14 |
| 1811470784 | Ltc of Berryville, LLC | Skilled Nursing Facility | 500 Hammond Avenue, Berryville, AR 72616 | 2018-09-07 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1386140341 | Three Rivers Nursing and Rehabilitation LLC | Skilled Nursing Facility | 33904 Highway 63 E, Marked Tree, AR 72365-9521 | 2018-03-30 |
| 1093244097 | Salco Nc 2, Inc. | Skilled Nursing Facility | 6420 Alcoa Rd, Benton, AR 72015-6315 | 2017-06-05 |
| 1184168072 | Dierks Healthcare & Rehabilitation Center LLC | Skilled Nursing Facility | 402 S Arkansas Ave, Dierks, AR 71833-9001 | 2016-12-12 |
| Find all providers with the same taxonomy | ||||
| City | FORREST CITY |
| Zip Code | 72335 |
Please comment or provide details below to improve the information on EVERGREENE PROPERTIES OF NORTH CAROLINA,LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.