LONGBRANCH OUTPATIENT RECOVERY LLC NPI 1184237653

NPI Information

NPI: 1184237653
Provider Name: LONGBRANCH OUTPATIENT RECOVERY, LLC

Doing Business As: LONGBRANCH WELLNESS

Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

Address:
335 W PARKER RD
JONESBORO, AR
ZIP 72404
Phone: (504) 635-3535
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LONGBRANCH OUTPATIENT RECOVERY, LLC is a substance abuse rehabilitation facility in Jonesboro, AR. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. LONGBRANCH OUTPATIENT RECOVERY, LLC NPI is 1184237653. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Longbranch Wellness.

The provider's business location address is:

335 W PARKER RD
JONESBORO, AR
ZIP 72404-409
Phone: (504) 635-3535
Fax: (985) 273-3869

The provider's authorized official is Emily Elizabeth Meyers .
The authorized official title is Ceo and has the following contact phone number (920) 309-0541.

The CLIA number assigned to this NPI record is 04D2299862 - other - addiction and behavioral with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/25/2020 and was last updated on 2/28/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	103TC0700X	Psychologist	Clinical	No
2	103TC1900X	Psychologist	Counseling	No
3	103TP0016X	Psychologist	Prescribing (Medical)	No
4	1041C0700X	Social Worker	Clinical	No
5	106H00000X	Marriage & Family Therapist		No
6	2084P0800X	Psychiatry & Neurology	Psychiatry	No
7	2084P0802X	Psychiatry & Neurology	Addiction Psychiatry	No
8	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
9	261QR0800X	Clinic/Center	Recovery Care	No
10	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
11	101YM0800X	Counselor	Mental Health	No
12	101YP2500X	Counselor	Professional	No
13	324500000X	Substance Abuse Rehabilitation Facility		Yes

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

NPI Synchronization or Removal

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