CLARKSVILLE CONVALESCENT HOME
NPI 1124015680
Skilled Nursing Facility in Clarksville, AR

Active since September 30, 2005
400 OAK CT, CLARKSVILLE, AR 72830(479) 754-8611(479) 754-2369 Get Directions Write a Review

NPPES record last updated: June 10, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clarksville Convalescent Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARKSVILLE CONVALESCENT HOME (NPI 1124015680) is a healthcare organization registered as a skilled nursing facility in Clarksville, Arkansas and active in the NPI registry since September 2005. The organization lists Patricia Miller, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1124015680
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameKMJ ENTERPRISES CLARKSVILLE LLC
Location Address400 OAK CTClarksville, AR 72830-3778
Mailing Address400 Oak CtClarksville, AR 72830-3778 · (479) 754-8611 · Fax (479) 754-2369
Fax(479) 754-2369
Organization SubpartYesParent: Kmj Management
Authorized OfficialPatricia MillerPresident/ceo · (479) 636-5716
Enumeration DateSeptember 30, 2005
Last NPPES UpdateJune 10, 2008
NPI 1124015680 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in AR · 702
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
400 OAK CT, Clarksville, AR 72830

Other Names 1

Doing Business AsClarksville Convalescent Home

Other Identifiers 2

Medicare OSCAR/certification045360AR
Medicaid119715311AR

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
400 OAK CT
CLARKSVILLE, AR 72830
Skilled Nursing Facility
400 OAK CT
CLARKSVILLE, AR 72830
Skilled Nursing Facility
400 OAK CT
CLARKSVILLE, AR 72830
Occupational Therapy Assistant
400 OAK CT
CLARKSVILLE, AR 72830

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kmj Enterprises Clarksville LLC's NPI number?

The NPI number for Kmj Enterprises Clarksville LLC is 1124015680. It was assigned to this organization in the NPPES registry on September 30, 2005. The provider is doing business as Clarksville Convalescent Home.

Where is Kmj Enterprises Clarksville LLC located?

Kmj Enterprises Clarksville LLC is located at 400 Oak Ct, Clarksville, AR 72830. The listed phone number is (479) 754-8611.

What is Kmj Enterprises Clarksville LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Kmj Enterprises Clarksville LLC was last updated on June 10, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.