PINEY RIDGE TREATMENT CENTER, LLC (NPI# 1447380423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447380423 |
| Entity Type | Organization |
| Organization Name | PINEY RIDGE TREATMENT CENTER, LLC |
| Practice Address |
4253 Crossover Rd Fayetteville AR 72703 |
| Mailing Address |
6100 Tower Cir Ste 1000 Franklin TN 37067-1509 |
| Practice Telephone | 4795871408 |
| Practice Fax Number | 4896841323 |
| Mailing Telephone | 6158616000 |
| Mailing Fax Number | 6152619685 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2018-10-17 |
| Authorized Official Name | MR. CHRISTOPHER L HOWARD (VP & SECRETARY) |
| Authorized Official Telephone | 6158616000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | AR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 162602125 | 05 |
| Other Name | Type Code |
|---|---|
| Amicare of Arkansas, LLC | Former Legal Business Name - Organization |
| Street Address |
4253 CROSSOVER RD |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003223066 | Chapmans Management Company | Psychiatric Residential Treatment Facility | 111 Lamon St, Fayetteville, NC 28301-4901 | 2014-07-22 |
| 1124144563 | Texarkana Behavioral Associates, L.c. | Psychiatric Residential Treatment Facility | 4253 N. Crossover Rd., Fayetteville, AR 72703-4593 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932746070 | Habilitation Center, LLC | Psychiatric Residential Treatment Facility | 161 Skunk Hollow Road, Conway, AR 72032 | 2019-12-09 |
| 1225211741 | Woodridge of Forrest City, LLC | Psychiatric Residential Treatment Facility | 603 Kittel Rd, Forrest City, AR 72335-7728 | 2007-12-06 |
| 1114915840 | Psychiatric Services, Inc | Psychiatric Residential Treatment Facility | 5208 Kavanaugh Blvd, Suite 4, Little Rock, AR 72207-4609 | 2005-10-06 |
| 1689020844 | Woodridge Northwest, LLC | Psychiatric Residential Treatment Facility | 2466 S 48th St, Springdale, AR 72762-6683 | 2016-05-06 |
| 1154707461 | Valley Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 10301 Mayo Dr, Barling, AR 72923-1660 | 2015-08-10 |
| 1013278233 | Ladonna Kay Delee | Psychiatric Residential Treatment Facility | 3204 E Moore Ave, Searcy, AR 72143-4826 | 2012-06-05 |
| 1396999801 | Youth Home, Inc | Psychiatric Residential Treatment Facility | 20400 Colonel Glenn Rd, Little Rock, AR 72210 | 2008-11-11 |
| 1134305436 | Woodridge Northeast, LLC | Psychiatric Residential Treatment Facility | 600 N 7th St, West Memphis, AR 72301 | 2008-01-16 |
| 1104033976 | Ameris of Arkansas, LLC | Psychiatric Residential Treatment Facility | 611 W Lee Ave, Osceola, AR 72370-3001 | 2007-05-17 |
| 1083820146 | Youth Home, Inc | Psychiatric Residential Treatment Facility | 20400 Colonel Glenn Rd, Little Rock, AR 72210-5323 | 2007-05-15 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
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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.