Diversicare Pinedale, LLC

NPI #1922096593 in Newport, Arkansas

Provider Information

NPI Number
1922096593
Entity Type
Organization
Organization Name
Diversicare Pinedale, LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Oct 7, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
1311 N PECAN ST
ZIP Code
72112-2816
Phone
(870) 523-9514

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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