NPI 1104814771

Diversicare Leasing Corp.

Organisation Skilled Nursing Facility Conway, AR

Practice location

Address: 2603 Dave Ward Dr, Conway, AR 72034-6771
Phone: (501) 329-2149
Fax: (501) 329-4916

Authorised official

Name: Raymond L. Tyler
Title: Executive Vice President and Coo
Phone: (615) 771-7575

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 534 (AR)

Other Skilled Nursing Facility providers in Arkansas →

Registry record

NPI: 1104814771
Entity type: Organization
NPI issued: 7 Oct 2005
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.