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| Facility Information | | Facility Name: | Bentonville Manor Nursing Home | | Mailing Address: | 224 South Main Street, Bentonville, AR 72712-5963 | | Physical Address: | 224 South Main Street, Bentonville, AR 72712-5963 | | County:
| Benton | | Phone Number: | 479-273-3373 | | Fax Number: | 479-273-0623 | | Administrator and Certifications
| | Administrator: | Cyndie L. Lyon | | Administrator License No.:
| 2157 | | Life Safety Code Years: | 1967 1981 | | Certifications: | XIX/XVIII | | Certified Beds | | Total Licensed Beds: | 95 | | Medicaid Beds: | 0 | | Medicare Beds: | 0 | | Medicaid/Medicare Beds: | 95 | | Private Beds: | 0 | | Classification: | Skilled Nursing Facility with dual certified beds (Medicaid/Medicare) | | Ownership and Financial Interest | | Entity Type: | Limited Liability Company | | Corporation Name: | Benton Nursing, LLC |
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