Pine Lane Healthcare

LBN: Kmj Enterprises Mountain Home Llc
Pine Lane Healthcare is an health care organization with primary practice located at 1100 Pine Tree Ln , Mountain Home AR 72653-4502. 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. Kmj Enterprises Mountain Home Llc can be contacted via phone (870) 425-6316, or through Miller, Patricia via phone (479) 636-5716.

Contact Information

Primary practice address
1100 Pine Tree Ln Mountain Home AR 72653-4502
Phone: (870) 425-6316
Fax: (870) 424-5197
Website:
Map and Directions
Authorized official contact:
Name: Miller, Patricia
Phone: (479) 636-5716

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 720 Arkansas

Profile Details

NPI number 1871580076
LBN Legal business name Kmj Enterprises Mountain Home Llc
DBA Doing business as Pine Lane Healthcare
Authorized official Miller, Patricia
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 3rd, 2005
Last updated Jun 13th, 2008 - about 16 years ago

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 1871580076 NPPES
Arkansas MEDICAID 119728311

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