Provider Demographics
NPI: | 1568970820 |
---|---|
Name: | VVR HEALTHCARE OPERATIONS, LLC |
Entity Type: | Organization |
Organization Name: | VVR HEALTHCARE OPERATIONS, LLC |
Other - Org Name: | THE VILLAGE AT VALLEY RANCH |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JOEY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WIGGINS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 501-412-5961 |
Mailing Address - Street 1: | PO BOX 8248 |
Mailing Address - Street 2: | |
Mailing Address - City: | SEARCY |
Mailing Address - State: | AR |
Mailing Address - Zip Code: | 72145-8248 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 501-412-5961 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6411 VALLEY RANCH DR |
Practice Address - Street 2: | |
Practice Address - City: | LITTLE ROCK |
Practice Address - State: | AR |
Practice Address - Zip Code: | 72223-4543 |
Practice Address - Country: | US |
Practice Address - Phone: | 501-868-8857 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-01-19 |
Last Update Date: | 2020-05-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AR | 314000000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 314000000X | Nursing & Custodial Care Facilities | Skilled Nursing Facility |