AUTUMN HILL
NPI 1811470784
Skilled Nursing Facility in Berryville, AR

Active since September 07, 2018CLIA 04D0468423 · Waiver
500 HAMMOND AVENUE, BERRYVILLE, AR 72616(870) 423-6966 Get Directions Write a Review

NPPES record last updated: September 7, 2018. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Autumn Hill NPPES

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

AUTUMN HILL (NPI 1811470784) is a healthcare organization registered as a skilled nursing facility in Berryville, Arkansas and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through July 15, 2027 and lists Mathias Dasal, Manager, as its authorized official.

NPPES Registry Identity

NPI1811470784
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLTC OF BERRYVILLE, LLC
Location Address500 HAMMOND AVENUEBerryville, AR 72616
Mailing Address3750 Osage Beach PkwyOsage Beach, MO 65065-2179
Organization SubpartNo
Authorized OfficialMathias DasalManager · (573) 746-7100
Enumeration DateSeptember 7, 2018
✔ NPI 1811470784 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.
500 HAMMOND AVENUE, Berryville, AR 72616

Other Names 1

Doing Business AsAutumn Hill

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 04D0468423

Autumn Hill · Berryville, AR
Active · expires Jul 15, 2027
CLIA Number04D0468423
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJuly 16, 2025
Certificate Expiration DateJuly 15, 2027
Laboratory DirectorJosh Kilgore
Laboratory Phone(870) 423-6966
Laboratory LocationAutumn Hill500 Hammonds Avenue, Berryville, AR 72616
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Ltc Of Berryville, LLC's NPI number?

The NPI number for Ltc Of Berryville, LLC is 1811470784. It was assigned to this organization in the NPPES registry on September 7, 2018. The provider is doing business as Autumn Hill.

Where is Ltc Of Berryville, LLC located?

Ltc Of Berryville, LLC is located at 500 Hammond Avenue, Berryville, AR 72616. The listed phone number is (870) 423-6966.

What is Ltc Of Berryville, LLC's specialty?

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

Does Ltc Of Berryville, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D0468423) is associated with this NPI, valid through July 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ltc Of Berryville, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and Ambetter from Superior HealthPlan and 2 other insurers list Ltc Of Berryville, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ltc Of Berryville, LLC was last updated on September 7, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.