Provider Demographics
NPI:1548634074
Name:SOMERSET SENIOR LIVING AT PREMIER
Entity type:Organization
Organization Name:SOMERSET SENIOR LIVING AT PREMIER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:FAIRCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-955-2108
Mailing Address - Street 1:3600 RICHARDS RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2921
Mailing Address - Country:US
Mailing Address - Phone:501-955-2108
Mailing Address - Fax:501-955-9517
Practice Address - Street 1:3600 RICHARDS RD
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2921
Practice Address - Country:US
Practice Address - Phone:501-955-2108
Practice Address - Fax:501-955-9517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA045357Medicare Oscar/Certification