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04D0468704 CLIA NUMBER - PROMENADE HEALTH AND REHAB SRN MANAGEMENT 2, LLC

Laboratory Demographics

CLIA Number: 04D0468704

Facility Name: PROMENADE HEALTH AND REHAB SRN MANAGEMENT 2, LLC

Facility Address:
1101 S PROMENADE BOULEDVARD
ROGERS, AR
ZIP 72758
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Facility Phone Number: 479 268-3989

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver
NPI Number: 1992185789

Taxonomy: 314000000X - 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.

CLIA Record

Field Name Field Value
CLIA Number 04D0468704
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PROMENADE HEALTH AND REHAB SRN MANAGEMENT 2, LLC
Street 1101 S PROMENADE BOULEDVARD
City ROGERS
State AR
ZIP 72758
Phone 479 268-3989
CertificateType 4
CertificateEffectiveDate 3/17/2023
CertificateExpirationDate 3/16/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024