| Sycamore Springs Senior Living, Llc | |
|
165 Jerry Baker Ln Mountain Home AR 72653-9485 | |
| (870) 232-0540 | |
| (870) 232-0541 |
| Full Name | Sycamore Springs Senior Living, Llc |
|---|---|
| Speciality | General Practice |
| Location | 165 Jerry Baker Ln, Mountain Home, Arkansas |
| Authorized Official Name and Position | Kenneth Nick Arnold (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8702320540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sycamore Springs Senior Living, Llc 165 Jerry Baker Ln Mountain Home AR 72653-9485 Ph: (870) 232-0540 | Sycamore Springs Senior Living, Llc 165 Jerry Baker Ln Mountain Home AR 72653-9485 Ph: (870) 232-0540 |
| NPI Number | 1437938461 |
|---|---|
| Provider Enumeration Date | 09/28/2023 |
| Last Update Date | 12/13/2023 |
| Medicare PECOS PAC ID | 1456708999 |
|---|---|
| Medicare Enrollment ID | O20231106001970 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437938461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Timothy C Paden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992761555 PECOS PAC ID: 4587740725 Enrollment ID: I20101019001418 |
| Provider Name | Deborah Stepp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285180984 PECOS PAC ID: 4385924893 Enrollment ID: I20161129001045 |
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