Provider Demographics
NPI:1942638044
Name:BCC MOUNTAIN HOME OPERATIONS, LLC
Entity Type:Organization
Organization Name:BCC MOUNTAIN HOME OPERATIONS, LLC
Other - Org Name:ELMCROFT OF MOUNTAIN HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:502-753-6004
Mailing Address - Street 1:9510 ORMSBY STATION RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4081
Mailing Address - Country:US
Mailing Address - Phone:502-753-6004
Mailing Address - Fax:502-753-6104
Practice Address - Street 1:715 W 6TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3421
Practice Address - Country:US
Practice Address - Phone:870-425-6868
Practice Address - Fax:870-425-7310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR022310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility