Provider Demographics
NPI:1922677129
Name:JSKMF, LLC
Entity Type:Organization
Organization Name:JSKMF, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SHANNON
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-835-3988
Mailing Address - Street 1:903 BORGOGNONI DR
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-1623
Mailing Address - Country:US
Mailing Address - Phone:870-265-5337
Mailing Address - Fax:
Practice Address - Street 1:903 BORGOGNONI DR
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653-1623
Practice Address - Country:US
Practice Address - Phone:870-265-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility