Diversicare Leasing Corp.
NPI #1225026800 in Walnut Ridge, Arkansas
Provider Information
- NPI Number
- 1225026800
- 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
- 1500 W MAIN ST
- City
- Walnut Ridge
- State
- Arkansas
- ZIP Code
- 72476-1434
- Phone
- (870) 886-9022
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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