Provider Demographics
NPI:1467731174
Name:PARAGOULD GH OPERATIONS LLC
Entity Type:Organization
Organization Name:PARAGOULD GH OPERATIONS LLC
Other - Org Name:BELLE MEADE, A REHABILITATION AND RESIDENT CARE FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-236-7104
Mailing Address - Street 1:2200 CHATEAU BLVD
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-6264
Mailing Address - Country:US
Mailing Address - Phone:870-236-7104
Mailing Address - Fax:870-239-9787
Practice Address - Street 1:2200 CHATEAU BLVD
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-6264
Practice Address - Country:US
Practice Address - Phone:870-236-7104
Practice Address - Fax:870-239-9787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA045170Medicare Oscar/Certification