PEACHTREE LANE AT MENA LLC NPI 1740407493

NPI Information

NPI: 1740407493
Provider Name: PEACHTREE LANE AT MENA, LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
1803 CORDIE DR
MENA, AR
ZIP 71953
Phone: (479) 394-2600
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PEACHTREE LANE AT MENA, LLC is an assisted living facility in Mena, AR. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. PEACHTREE LANE AT MENA, LLC NPI is 1740407493. The provider is registered as an organization entity type.

The provider's business location address is:

1803 CORDIE DR
MENA, AR
ZIP 71953-340
Phone: (479) 394-2600
Fax: (479) 394-2608

The provider's authorized official is Annette Landrum .
The authorized official title is Managing Member Owner and has the following contact phone number (479) 783-0718.

The enumeration date for this NPI number is 4/20/2007 and was last updated on 8/22/2020.

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
1	310400000X	Assisted Living Facility		008	ARKANSAS	Yes

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: 4/28/2024

NPI Synchronization or Removal

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