Provider Demographics
NPI:1053318485
Name:BLM CO. INC.
Entity Type:Organization
Organization Name:BLM CO. INC.
Other - Org Name:OAK RIDGE NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-862-5511
Mailing Address - Street 1:501 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-6573
Mailing Address - Country:US
Mailing Address - Phone:870-862-5511
Mailing Address - Fax:870-863-3240
Practice Address - Street 1:501 HUDSON ST
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-6573
Practice Address - Country:US
Practice Address - Phone:870-862-5511
Practice Address - Fax:870-863-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR0549314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR109136311Medicaid
AR045271Medicare ID - Type Unspecified