CONWAY COUNTY COMMUNITY SERVICE INC. (NPI# 1134354400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134354400 |
| Entity Type | Organization |
| Organization Name | CONWAY COUNTY COMMUNITY SERVICE INC. |
| Other Organization Name | COMMUNITY SERVICE INC. - RUSSELLVILLE |
| Practice Address |
1505 S Oswego Ave Russellville AR 72802-2673 |
| Practice Telephone | 4799673370 |
| Practice Fax Number | 4799672775 |
| Mailing Telephone | 4799673370 |
| Mailing Fax Number | 4799672775 |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2009-05-15 |
| Authorized Official Name | STEVE WILLBANKS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5013544589 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Community Service Inc. - Russellville | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903884 | Conway County Community Service Inc. | Community/Behavioral Health | 616 E. Emma Avenue, Suite 244, Springdale, AR 72764 | 2020-08-20 |
| 1255994158 | Conway County Community Service Inc. | Community/Behavioral Health | 200 S Peabody Ave, Mountain View, AR 72560-6311 | 2019-04-16 |
| 1013142355 | Conway County Community Service Inc. | Community/Behavioral Health | 203 N 4th St, Ozark, AR 72949-2701 | 2009-05-15 |
| 1699909911 | Conway County Community Service Inc. | Community/Behavioral Health | 816 N Creek Dr, Conway, AR 72032-4711 | 2009-05-14 |
| 1871727198 | Conway County Community Service Inc. | Community/Behavioral Health | 1415 S Oswego Ave, Russellville, AR 72802-2646 | 2009-05-14 |
| 1770631467 | Conway County Community Service Inc. | Community/Behavioral Health | 100 S Cherokee St., Morrilton, AR 72110 | 2007-01-08 |
| 1851903157 | Conway County Community Service Inc. | Community/Behavioral Health | 1200 W Walnut St Ste B1100, Rogers, AR 72756-3562 | 2020-08-18 |
| 1184287088 | Conway County Community Service Inc. | Community/Behavioral Health | 115 W Clinton St, Heber Springs, AR 72543-3135 | 2019-04-16 |
| 1053546176 | Conway County Community Service Inc. | Community/Behavioral Health | 818 N Creek Dr, Conway, AR 72032-4711 | 2009-05-19 |
| 1316172430 | Conway County Community Service Inc. | Community/Behavioral Health | 730 Boston St, Danville, AR 72833 | 2009-05-19 |
| Street Address |
1505 S OSWEGO AVE |
| City | RUSSELLVILLE |
| State | AR |
| Zip Code | 72802-2673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548307853 | Kathy Gipson | Counselor | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2007-01-30 |
| 1730674250 | Alex Jordan Dorch | Counselor | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2018-06-27 |
| 1548627565 | James C Harris | Counselor | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2016-01-21 |
| 1275912263 | Community Service, Inc | Case Manager/Care Coordinator | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2015-05-22 |
| 1417192279 | Tanzie Simmons | Behavioral Analyst | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2008-12-09 |
| 1356586309 | Jennifer Dawn Broussard | Behavioral Analyst | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2008-12-04 |
| 1902051170 | Kathy Lavern Robberson | Behavioral Analyst | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2008-12-01 |
| 1295863819 | Timothy Isaac Bostick | Behavioral Analyst | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2007-03-02 |
| 1821137084 | John Paul Senn | Marriage & Family Therapist | 1505 S Oswego Ave, Russellville, AR 72802-2673 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316587850 | Friends of Freedom House Inc. | Counselor | 404 Lake Front Drive, Russellville, AR 72802 | 2020-01-13 |
| 1922527027 | Sarah Huey | Counselor | 1505 S. Oswego Ave., Russellville, AR 72802 | 2017-09-11 |
| 1437555315 | Laura Easter | Case Manager/Care Coordinator | 1505 S, Oswego Ave., Russellville, AR 72802 | 2014-11-05 |
| 1982005252 | Yariela Borras | Case Manager/Care Coordinator | 1415 S. Oswego Avenue, Russellville, AR 72802 | 2014-09-05 |
| 1477953818 | Kelly Sutton | Case Manager/Care Coordinator | 1505 S. Oswego Avenue, Russellville, AR 72802 | 2014-09-03 |
| 1891080909 | Tera Dacus | Counselor | 1505 S. Oswego Ave, Russellville, AR 72802 | 2011-06-16 |
| 1992034763 | Central Arkansas Surgical Center, LLC | Clinic/Center | 151 East Aspen Ln, Russellville, AR 72802 | 2009-12-08 |
| 1134302854 | Twin Rivers Respiratory Care, Inc | Durable Medical Equipment & Medical Supplies | 1400 S Knoxville Ave, Russellville, AR 72802 | 2007-12-17 |
| 1003945007 | Phyllis Wells | Case Manager/Care Coordinator | 1400 East 16th St, Russellville, AR 72802 | 2007-03-05 |
| 1609902295 | Debi C Day Damron Burns | Case Manager/Care Coordinator | 1402 East 16th St, Russellville, AR 72802 | 2007-02-26 |
| Find all providers in zip 72802 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568943140 | Real Development Corporation | Community/Behavioral Health | 1310 W Main St Ste 201, Russellville, AR 72801-2803 | 2018-08-22 |
| 1821495052 | Teesha A. Finkbeiner, Lcsw, P.a. | Community/Behavioral Health | 701 E Main St Ste 2, Russellville, AR 72801-5209 | 2014-12-03 |
| 1932411808 | Alternative Opportunities | Community/Behavioral Health | 1610 S Arkansas Avenue Suite 1, Russellville, AR 72801-2531 | 2010-07-08 |
| 1871727198 | Conway County Community Service Inc. | Community/Behavioral Health | 1415 S Oswego Ave, Russellville, AR 72802-2646 | 2009-05-14 |
| 1861615064 | Dayspring Services of Arkansas LLC | Community/Behavioral Health | 2424 W Main St, Russellville, AR 72801-2531 | 2007-04-10 |
| 1821525932 | Words of Peace Counseling Services, Inc. | Community/Behavioral Health | 211 E 4th St, Russellville, AR 72801-5133 | 2017-05-19 |
| 1477095065 | Points of Light Counseling Services, Inc. | Community/Behavioral Health | 211 E 4th St, Russellville, AR 72801-5133 | 2016-11-14 |
| 1164836417 | Grace Counseling, Inc. | Community/Behavioral Health | 701 E Main St, Suite 3, Russellville, AR 72801-5247 | 2014-06-15 |
| 1477806925 | Healthy U | Community/Behavioral Health | 911 W B St, Russellville, AR 72801-3501 | 2012-10-22 |
| 1407009954 | Anne Keenan Lcsw and Associates | Community/Behavioral Health | 2621 W Main St, Suite 7, Russellville, AR 72801-2534 | 2008-10-28 |
| Find all providers in RUSSELLVILLE | ||||
| City | RUSSELLVILLE |
| Zip Code | 72802 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.