INDIAN ROCK VILLAGE, LLC (NPI# 1780633222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780633222 |
| Entity Type | Organization |
| Organization Name | INDIAN ROCK VILLAGE, LLC |
| Practice Address |
265 Dave Creek Parkway Fairfield Bay AR 72088-3136 |
| Mailing Address |
265 Dave Creek Pkwy Fairfield Bay AR 72088-3106 |
| Practice Telephone | 5018843210 |
| Practice Fax Number | 5018846800 |
| Mailing Telephone | 5018843210 |
| Mailing Fax Number | 5018846800 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2013-12-04 |
| Authorized Official Name | MR. EDWARD VICTOR HOLMAN (PRESIDENT) |
| Authorized Official Telephone | 5012240846 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 452 | AR | Nursing & Custodial Care Facilities |
| Street Address |
265 DAVE CREEK PARKWAY |
| City | FAIRFIELD BAY |
| State | AR |
| Zip Code | 72088-3136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609036789 | S M Hassan Bashiri | Dentist | 203 Lakeview Dr, Fairfield Bay, AR 72088 | 2008-06-12 |
| 1255429726 | Boston Mountain Rural Health Center, Inc | Clinic/Center | 110 Village Village Place, Fairfield Bay, AR 72088 | 2006-10-10 |
| 1659781151 | Baptist Health | Clinic/Center | 110 Village Ln, Suite 2b, Fairfield Bay, AR 72088 | 2014-05-06 |
| 1033758420 | Jenny Treece | Pharmacist | 367 Dave Creek Parkway, Fairfield, AR 72088-1223 | 2020-01-02 |
| 1861454506 | City of Fairfield Bay | Ambulance | 101 Little Rock Drive, Fairfield Bay, AR 72088-1271 | 2006-04-06 |
| 1780168948 | White River Health System, Inc. | Clinic/Center | 110 Village Pl, Fairfield Bay, AR 72088-2838 | 2018-09-24 |
| 1215066998 | Village Gardens | Assisted Living Facility | 265 Dave Creek Pkwy, Fairfield Bay, AR 72088-3106 | 2007-03-05 |
| 1477960581 | Ozark Medical Clinic, LLC | Family Medicine | 383 Dave Creek Pkwy, Fairfield Bay, AR 72088-3631 | 2014-07-21 |
| 1356335566 | Bennett Health Services, Inc. | Durable Medical Equipment & Medical Supplies | 367 Dave Creek Pkwy, Fairfield Bay, AR 72088-3631 | 2005-09-01 |
| 1578758082 | Rebecca M. Mcallister | Physical Therapist | 107 Eagle Ridge Trce, Fairfield Bay, AR 72088-4512 | 2007-09-07 |
| Find all providers in zip 72088 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447659669 | Parkway Health Center, Inc. | Nursing Facility/Intermediate Care Facility | 14324 Chenal Pkwy, Little Rock, AR 72211-5805 | 2014-08-14 |
| 1093138059 | Little River Nursing and Rehab | Nursing Facility/Intermediate Care Facility | 162 Hwy 32-2a, Ashdown, AR 71822-8689 | 2014-01-28 |
| 1295071322 | Courtney Bickerstaff Apn,pllc | Nursing Facility/Intermediate Care Facility | 1309 Ashlea Place Dr, Bryant, AR 72022-9159 | 2012-12-18 |
| 1992014930 | Jane Ellen Phillips Apn Pllc | Nursing Facility/Intermediate Care Facility | 511 Farr Shores Dr, Hot Springs, AR 71913-9622 | 2010-09-24 |
| 1639480049 | Smith Drug Company | Nursing Facility/Intermediate Care Facility | 1104 Jones Rd, Paragould, AR 72450-7579 | 2010-06-30 |
| 1760627640 | Cavhs | Nursing Facility/Intermediate Care Facility | 2220 Ft Roots Drive, North Little Rock, AR 72114-1706 | 2008-12-08 |
| 1023283884 | A & C Fairways and Greenns Inc. | Nursing Facility/Intermediate Care Facility | 106 No. Third St., Marmaduke, AR 72443 | 2008-04-23 |
| 1568680742 | David E. Puryear Center | Nursing Facility/Intermediate Care Facility | 2806 Fox Meadow Ln, Jonesboro, AR 72404-9346 | 2007-04-23 |
| 1275673642 | Countryside Manor LLC | Nursing Facility/Intermediate Care Facility | 300 S Thompson Rd, Lamar, AR 72846-9423 | 2007-02-07 |
| 1760520936 | Greenhurst, Inc. | Nursing Facility/Intermediate Care Facility | 226 Skyler Dr, Pob 458, Charleston, AR 72933-9337 | 2007-02-01 |
| Find all providers with the same taxonomy | ||||
| City | FAIRFIELD BAY |
| Zip Code | 72088 |
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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.