Diversicare Of Tupelo

LBN: Diversicare Of Tupelo, Llc
Diversicare Of Tupelo is an health care organization with primary practice located at 2273 S Eason Blvd , Tupelo MS 38804-5900. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Diversicare Of Tupelo, Llc can be contacted via phone (662) 842-2461, or through Weishaar, Matthew J via phone (615) 550-9459.

Contact Information

Primary practice address
2273 S Eason Blvd Tupelo MS 38804-5900
Phone: (662) 842-2461
Fax: (662) 841-2884
Website:
Map and Directions
Authorized official contact:
Name: Weishaar, Matthew J
Phone: (615) 550-9459

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 417 Mississippi

Profile Details

NPI number 1447705439
LBN Legal business name Diversicare Of Tupelo, Llc
DBA Doing business as Diversicare Of Tupelo
Authorized official Weishaar, Matthew J
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 18th, 2016
Last updated Apr 7th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447705439 NPPES
Mississippi MEDICAID 00023145

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