PEACHTREE LANE AT MENA, LLC (NPI# 1740407493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1740407493 |
Entity Type | Organization |
Organization Name | PEACHTREE LANE AT MENA, LLC |
Practice Address |
1803 Cordie Dr Mena AR 71953-9340 |
Mailing Address |
1422 Fresno St Fort Smith AR 72901-7065 |
Practice Telephone | 4793942600 |
Practice Fax Number | 4793942608 |
Mailing Telephone | 4797830718 |
Mailing Fax Number | 4797838564 |
Enumeration Date | 2007-04-20 |
Last Update Date | 2020-08-22 |
Authorized Official Name | ANNETTE LANDRUM (MANAGING MEMBER OWNER) |
Authorized Official Telephone | 4797830718 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | 008 | AR | Nursing & Custodial Care Facilities |
Street Address |
1803 CORDIE DR |
City | MENA |
State | AR |
Zip Code | 71953-9340 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518120740 | Peachtree Mena LLC | Assisted Living Facility | 1803 Cordie Dr, Mena, AR 71953-9340 | 2008-07-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174166623 | Joshua Daniel Sirkis | Physical Therapist | 500 Crestwood Circle Suite G, Mena, AR 71953 | 2019-10-28 |
1841639960 | Village Apothecary, Inc. | Durable Medical Equipment & Medical Supplies | 134 S George, Mt Ida, AR 71953 | 2013-06-21 |
1922326586 | Boone Home Healthcare, Inc. | Durable Medical Equipment & Medical Supplies | 803-a Highway 71 North, Mena, AR 71953 | 2010-05-06 |
1841529112 | Chad Hill | Hearing Instrument Specialist | 601 W Hwy 71 N, Mena, AR 71953 | 2009-12-16 |
1467612085 | Kent Allen Schnetzler | Orthopaedic Surgery | 400 Crestwood Circle, Suite L, Mena, AR 71953 | 2008-06-17 |
1710101548 | Family Dentistry | Dentist | 701 C 7th Street, Mena, AR 71953 | 2007-04-12 |
1629291455 | Jennifer Rowland | Occupational Therapist | 1801 Hamilton Avenue, Mena, AR 71953 | 2007-04-10 |
1093886822 | Alina Mielnick | Urology | 601 Bd Hwy 71 N, Mena, AR 71953 | 2006-11-13 |
1821195256 | Robert Martin Cohen | Psychiatry & Neurology | 311 North Morrow Street, Mena, AR 71953 | 2006-09-20 |
1730284357 | Sidney H Simpson | Chiropractor | 1402-b Hwy 71 S, Mena, AR 71953 | 2006-09-14 |
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Taxonomy Code | 310400000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639588585 | Benton Senior Living, LLC | Assisted Living Facility | 1180 Highway 71 S, Mena, AR 71953-3908 | 2014-08-05 |
1013200732 | Ouachita Senior Community Development, Lp | Assisted Living Facility | 1341 S Mena St, Mena, AR 71953-4619 | 2011-05-27 |
1518120740 | Peachtree Mena LLC | Assisted Living Facility | 1803 Cordie Dr, Mena, AR 71953-9340 | 2008-07-08 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518517127 | Peachtree Village, LLC | Assisted Living Facility | 1500 Fresno St, Fort Smith, AR 72901-7023 | 2019-09-16 |
1427539600 | Peachtree Village of Farmington, LLC | Assisted Living Facility | 55 W Rainsong St, Farmington, AR 72730-8635 | 2018-08-24 |
1437654670 | Eldercare of Arkansas V, Inc. | Assisted Living Facility | 601 E. Mountain Springs Road, Cabot, AR 72023 | 2018-03-29 |
1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
1750897039 | Green Acre Easy Lliving | Assisted Living Facility | 2407 W Oak St, Rogers, AR 72758-3943 | 2017-12-21 |
1962912626 | Lincolin Co Assisted Living | Assisted Living Facility | 142 Teva Dr, Star City, AR 71667-4253 | 2017-10-09 |
1043743768 | Peachtree Village At Holiday Island | Assisted Living Facility | 5 Park Dr, Holiday Island, AR 72631-9388 | 2017-04-10 |
1740645456 | Providence PCc of Springdale | Assisted Living Facility | 2175 Orchard St, Springdale, AR 72764-6357 | 2015-12-22 |
1649640236 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 200 Good Samaritan Dr, Mountain Home, AR 72653-9325 | 2015-09-25 |
1427444124 | Holiday Island Operations, LLC | Assisted Living Facility | 89 Hillside Drive, Holiday Island, AR 72631 | 2015-04-09 |
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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.