Diversicare Leasing Corp.

Skilled Nursing Facility · Conway, AR

Organization Active NPI

NPI number 1104814771

Practice location

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

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NPI record

NPI
1104814771
Entity type
Organization (Type 2)
Enumeration date
October 7, 2005
Last updated
August 22, 2020
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Skilled Nursing Facility Primary 314000000X 534 AR

Authorized official

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

Other names

  • Conway Healthcare and Rehabilitation Center

About Diversicare Leasing Corp.

Diversicare Leasing Corp. is a healthcare organization registered in the NPI registry with the primary taxonomy Skilled Nursing Facility (code 314000000X). The practice location is 2603 Dave Ward Dr, Conway, AR 72034-6771. The NPI number 1104814771 was assigned on October 7, 2005 and the record was last updated on August 22, 2020.

Diversicare Leasing Corp. lists a license in the registry: #534 (AR) for Skilled Nursing Facility. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Raymond L. Tyler Jr., Executive Vice President and COO.

Frequently asked questions

What is the NPI number of Diversicare Leasing Corp.?

The NPI number is 1104814771.

What is the phone number of Diversicare Leasing Corp.?

The phone number listed for the practice location is (501) 329-2149.

Where is Diversicare Leasing Corp. located?

2603 Dave Ward Dr, Conway, AR 72034-6771.

What is the taxonomy code for Diversicare Leasing Corp.?

The primary taxonomy code is 314000000X – Skilled Nursing Facility.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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