SHORT MOUNTAIN LODGE RESIDENTIAL CARE NPI 1114485471

Custodial Care Facility (Adult Care Home) in Paris, AR

NPI 1114485471 Organization Custodial Care Facility Adult Care Home

About SHORT MOUNTAIN LODGE RESIDENTIAL CARE

Short Mountain Lodge Residential Care is a provider established in Paris, Arkansas specializing in custodial care facility (adult care home) . The NPI number of Short Mountain Lodge Residential Care is 1114485471 and was assigned on March 2019. The practitioner's primary taxonomy code is 311ZA0620X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Linda Short (Owner)

NPI

1114485471

Provider NameSHORT MOUNTAIN LODGE RESIDENTIAL CARE
Provider Location Address2721 W WALNUT ST PARIS, AR 72855
Provider Mailing Address2721 W WALNUT ST PARIS, AR 72855
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date03-06-2019
Last Update Date03-06-2019


Primary Taxonomy

Taxonomy Code311ZA0620X
ClassificationCustodial Care Facility
TypeNursing & Custodial Care Facilities
SpecializationAdult Care Home
Taxonomy DescriptionA custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Business Address

SHORT MOUNTAIN LODGE RESIDENTIAL CARE
2721 W WALNUT ST
PARIS, AR
ZIP 72855
Phone: (479) 963-2255

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Mailing Address

SHORT MOUNTAIN LODGE RESIDENTIAL CARE
2721 W WALNUT ST
PARIS, AR
ZIP 72855
Phone: (479) 963-2255



Authorized Official

Authorized Official Name LINDA SHORT
Authorized Official TitleOWNER
Authorized Official Phone(479) 452-4949

Other Providers at the same location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1427483783 SARAH GANN
Individual
Case Manager/Care Coordinator2721 W WALNUT ST
PARIS, AR 72855
(479) 452-5040
1144632902 JODI ARRERA
Individual
Case Manager/Care Coordinator2721 W WALNUT ST
PARIS, AR 72855
(479) 452-5040
1811455157 COURTNEY HEMBRA QBHP
Individual
Case Manager/Care Coordinator2721 W WALNUT ST
PARIS, AR 72855
(479) 963-1448
1033364344PERSPECTIVES BEHAVIORAL HEALTH MANAGEMENT, LLC
Organization
Counselor (Mental Health)2721 W WALNUT ST
PARIS, AR 72855
(479) 963-1448
1336773076WESTERN ARKANSAS COUNSELING AND GUIDANCE CENTER, INC.-RCF PARIS
Organization
Community/Behavioral Health2721 W WALNUT ST
PARIS, AR 72855
(479) 452-6650

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.