DIVERSICARE LEASING CORP. (NPI# 1760470348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760470348 |
| Entity Type | Organization |
| Organization Name | DIVERSICARE LEASING CORP. |
| Other Organization Name | OUACHITA NURSING AND REHABILITATION CENTER |
| Practice Address |
1411 Country Club Rd Camden AR 71701-4507 |
| Practice Telephone | 8708364111 |
| Practice Fax Number | 8708365671 |
| Mailing Telephone | 8708364111 |
| Mailing Fax Number | 8708365671 |
| Enumeration Date | 2005-10-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | RAYMOND L. TYLER JR. (EXECUTIVE VICE PRESIDENT AND COO) |
| Authorized Official Telephone | 6157717575 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 540 | AR | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Ouachita Nursing and Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154310431 | Diversicare Leasing Corp. | Skilled Nursing Facility | Houston Highway, Luling, TX 78648-0230 | 2005-10-19 |
| 1407845068 | Diversicare Leasing Corp. | Skilled Nursing Facility | 670 W 4th St, Yorktown, TX 78164-5092 | 2005-10-17 |
| 1154310712 | Diversicare Leasing Corp. | Skilled Nursing Facility | 611 N Broad St, Lampasas, TX 76550-1105 | 2005-10-17 |
| 1548258676 | Diversicare Leasing Corp. | Skilled Nursing Facility | 537 Spring St, Dover, TN 37058-3232 | 2005-10-12 |
| 1376531343 | Diversicare Leasing Corp. | Skilled Nursing Facility | 107 N Medina St, Lockhart, TX 78644-1919 | 2005-10-12 |
| 1538157649 | Diversicare Leasing Corp. | Skilled Nursing Facility | 200 Mayfield Dr, Smyrna, TN 37167-3019 | 2005-10-12 |
| 1124016241 | Diversicare Leasing Corp. | Skilled Nursing Facility | 902 Buchanan Rd, New Tazewell, TN 37825-7410 | 2005-10-12 |
| 1538157664 | Diversicare Leasing Corp. | Skilled Nursing Facility | 158 Mount Pelia Rd, Martin, TN 38237-3812 | 2005-10-12 |
| 1780672873 | Diversicare Leasing Corp. | Skilled Nursing Facility | 2159 Dogwood Ridge Rd, Wheelersburg, OH 45694-9044 | 2005-10-12 |
| 1720076771 | Diversicare Leasing Corp. | Skilled Nursing Facility | Rte 32 E Howard Creek Rd, Sandy Hook, KY 41171 | 2005-10-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | DIVERSICARE LEASING CORP. | 1621 Galleria Boulevard, Brentwood, TN 37027 |
| Indiana Business Entities | DIVERSICARE LEASING CORP. | 1621 Galleria Blvd, Brentwood, TN 37027 |
| Street Address |
1411 COUNTRY CLUB RD |
| City | CAMDEN |
| State | AR |
| Zip Code | 71701-4507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295119956 | Camden Snf Operations LLC | Skilled Nursing Facility | 1411 Country Club Rd, Camden, AR 71701-4507 | 2015-07-13 |
| 1508299918 | Camden Operations, LLC | Skilled Nursing Facility | 1411 Country Club Rd, Camden, AR 71701-4507 | 2013-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104456854 | Teresa Mccann | Pharmacist | Brookshire's Pharmacy #85, 1345 Hwy 4 Spur Sw, Camden, AR 71701 | 2020-01-22 |
| 1366938870 | American Oncology Partners, P.a. | Internal Medicine | 115 Fairview Rd Sw, Camden, AR 71701 | 2018-07-09 |
| 1609236454 | Laquisha Kelley | Case Manager/Care Coordinator | 211 South Jackson Street, Camden, AR 71701 | 2016-03-07 |
| 1649654435 | Gerald Stinnett | Occupational Therapy Assistant | 431 Ouachita 51, Camden, AR 71701 | 2015-07-13 |
| 1902105232 | Joannie Phelps | Counselor | 301a Washington, Camden, AR 71701 | 2011-03-25 |
| 1053540732 | Judy Prince | Counselor | 115 Jefferson Sw, Camden, AR 71701 | 2009-07-02 |
| 1861641532 | Candace Bowen | Occupational Therapy Assistant | 1320 Maul North West Road, Camden, AR 71701 | 2008-09-17 |
| 1073739587 | Harmony Grove School District | Local Education Agency (LEA) | 401 Oua Rd 88, Camden, AR 71701 | 2007-04-17 |
| 1215055876 | Angela Mashel Rich | Counselor | 1269 California Sw, Camden, AR 71701 | 2007-03-26 |
| 1104954791 | Lisa H Stevens | Speech-Language Pathologist | 400 Maul Road, Camden, AR 71701 | 2007-03-02 |
| Find all providers in zip 71701 | ||||
| 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 |
|---|---|---|---|---|
| 1992142491 | Tiffany Jeanetta Rochon | Skilled Nursing Facility | 1021 Princess Ave, Camden, NJ 08103-2748 | 2013-05-24 |
| 1497973382 | Jacqueline Kilgore LLC | Skilled Nursing Facility | 365 Alpha St, Camden, AR 71701-3000 | 2007-04-23 |
| 1346302635 | Camden Operations, LLC | Skilled Nursing Facility | 105 Mechanic St, Camden, ME 04843-1811 | 2006-12-14 |
| 1457435844 | Palmetto Springdale Operating LLC | Skilled Nursing Facility | 146 Battleship Rd, Camden, SC 29020-2060 | 2006-10-24 |
| 1952321754 | Abigail House for Nursing and Rehabilitation LLC | Skilled Nursing Facility | 1105 - 1115 Linden St, Camden, NJ 08102-1029 | 2006-07-21 |
| 1407802853 | Medical Center Senior Services | Skilled Nursing Facility | 1875 Old Wire Rd, Camden, AR 71701-6080 | 2006-05-26 |
| 1669424800 | Ggnsc Camden LLC | Skilled Nursing Facility | 900 Magnolia Rd, Camden, AR 71701-4626 | 2006-05-16 |
| 1851765382 | Somerset Senior Living At Pine Hills | Skilled Nursing Facility | 900 Magnolia Rd, Camden, AR 71701-4626 | 2015-11-20 |
| 1295119956 | Camden Snf Operations LLC | Skilled Nursing Facility | 1411 Country Club Rd, Camden, AR 71701-4507 | 2015-07-13 |
| 1093116006 | Mari Carter | Skilled Nursing Facility | 105 Mechanic St, Camden, ME 04843-1811 | 2014-09-09 |
| Find all providers in CAMDEN | ||||
Please comment or provide details below to improve the information on DIVERSICARE LEASING CORP..
| 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.