DALLAS COUNTY NURSING HOME
NPI 1992706824
Skilled Nursing Facility in Fordyce, AR
- Organization
- Skilled Nursing Facility
- CLIA Number: 04D0689262
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 03-24-2027
About DALLAS COUNTY NURSING HOME
This page provides the complete NPI Profile along with additional information for Dallas County Nursing Home, a provider established in Fordyce, Arkansas operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1992706824 assigned on August 2005. The practitioner's primary taxonomy code is 314000000X with license number 659 (AR). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Mrs. Kathy Brookshire (Owner)
- NPI
- 1992706824 Verify this NPI
- Provider Name
- DALLAS COUNTY NURSING HOME
- Entity Type
- Organization
- Location Address
- 203 N CLIFTON ST FORDYCE, AR 71742
- Location Phone
- (870) 352-3625
- Location Fax
- (870) 352-5053
- Mailing Address
- 203 N CLIFTON ST FORDYCE, AR 71742
- Mailing Phone
- (870) 352-3625
- Mailing Fax
- (870) 352-5053
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-02-2005
- Last Update Date
- 08-22-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 659
- License State
- AR
- Taxonomy Description
- (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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 04D0689262
- Facility Type
- Hospital
- Certificate Effective Date
- March 25, 2025
- Certificate Expiration Date
- March 24, 2027
- Laboratory Director
- DR. GARY P. ANZALONE
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Dallas County Nursing Home after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1992706824, enumerated as an "organization" on August 02, 2005.
The provider is located at 203 N CLIFTON ST FORDYCE, AR 71742 and the phone number is (870) 352-3625.
Skilled Nursing Facility with taxonomy code 314000000X.
