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5 RESIDENTIAL LLC NPI 1104398460


NPI Information

NPI: 1104398460
Provider Name: 5 RESIDENTIAL LLC
Classification: Substance Abuse Rehabilitation Facility - 3245S0500X
Entity Type: Organization

Specialization: Substance Abuse Treatment, Children

Address:
2209 GRANT AVE STE A
JONESBORO, AR
ZIP 72401
Phone: (870) 333-5300
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5 RESIDENTIAL LLC is a substance abuse treatment and children substance abuse rehabilitation facility in Jonesboro, AR. The provider is a facility or distinct part of a facility for children that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. 5 RESIDENTIAL LLC NPI is 1104398460. The provider is registered as an organization entity type.

The provider's business location address is:

2209 GRANT AVE STE A
JONESBORO, AR
ZIP 72401-195
Phone: (870) 333-5300
Fax: (870) 333-5301

The provider's authorized official is Beau Hunter Eaves .
The authorized official title is Cfo and has the following contact phone number (870) 273-2096.

The enumeration date for this NPI number is 12/27/2018 and was last updated on 12/27/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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