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BANYAN HEALTHCARE SERVICES LLC NPI 1760458814


NPI Information

NPI: 1760458814
Provider Name: BANYAN HEALTHCARE SERVICES, LLC

Doing Business As: DIERKS HEALTH & REHAB CENTER

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 04D0948382

Address:
402 S. ARKANSAS AVE
DIERKS, AR
ZIP 71833
Phone: (870) 286-3100
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BANYAN HEALTHCARE SERVICES, LLC is a skilled nursing facility in Dierks, AR. The provider is (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. BANYAN HEALTHCARE SERVICES, LLC NPI is 1760458814. The provider is registered as an organization entity type.
The provider Is Doing Business As Dierks Health & Rehab Center.

The provider's business location address is:

402 S. ARKANSAS AVE
DIERKS, AR
ZIP 71833
Phone: (870) 286-3100
Fax: (870) 286-3030

The provider's authorized official is Kurt Lee Luth .
The authorized official title is Registered Agent and has the following contact phone number (501) 833-5627.

The CLIA number assigned to this NPI record is 04D0948382 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/28/2006 and was last updated on 7/9/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1314000000XSkilled Nursing Facility769ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1045346MEDICARE ID-TYPE UNSPECIFIEDARKANSASMEDICARE PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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