Organization
DIVERSICARE OF EUPORA, LLC
Active
Parent organization
DIVERSICARE LEASING COMPANY III, LLC
Other names
Diversicare of Eupora
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE LEASING COMPANY III, LLC
Authorized official
MATTHEW J WEISHAAR (CHIEF FINANCIAL OFFICER)
(615) 550-9459
Entity
Organization
Contact information
Practice address
156 E WALNUT AVE, EUPORA, MS 39744-2027
(662) 258-8293
(662) 258-2345
Mailing address
1621 GALLERIA BLVD, BRENTWOOD, TN 37027-2926
(615) 550-9453
(615) 620-7875
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
382
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00023049
—
MS
Enumeration date
08/18/2016
Last updated
04/07/2023
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