Diversicare Leasing Corp.

NPI #1205824885 in Mena, Arkansas

Provider Information

NPI Number
1205824885
Entity Type
Organization
Organization Name
Diversicare Leasing Corp.
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Oct 8, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
306 HORNBECK AVE
City
Mena
ZIP Code
71953-4338
Phone
(479) 394-3511

Authorized Official

Name
RAYMOND L. TYLER JR.
Title
EXECUTIVE VICE PRESIDENT AND COO
Phone
(615) 771-7575

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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