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RIVER LODGE ASSISTED LIVING LLC NPI 1912299660


NPI Information

NPI: 1912299660
Provider Name: RIVER LODGE ASSISTED LIVING LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
117 RIVERLODGE DRIVE
MOUNTAIN HOME, AR
ZIP 72653
Phone: (870) 607-0902
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RIVER LODGE ASSISTED LIVING LLC is an assisted living facility in Mountain Home, 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. RIVER LODGE ASSISTED LIVING LLC NPI is 1912299660. The provider is registered as an organization entity type.

The provider's business location address is:

117 RIVERLODGE DRIVE
MOUNTAIN HOME, AR
ZIP 72653
Phone: (870) 607-0902
Fax: (870) 607-0905

The provider's authorized official is Todd Parker Hightower .
The authorized official title is Owner and has the following contact phone number (479) 471-9797.

The enumeration date for this NPI number is 5/12/2011 and was last updated on 5/12/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility049ARKANSASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1185308794MEDICAIDARKANSAS

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

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