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CEDAR RIDGE INC NPI 1184848202


NPI Information

NPI: 1184848202
Provider Name: CEDAR RIDGE, INC
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization

CLIA Number: 04D2074939

Address:
107 THICKSTEN DR
ALMA, AR
ZIP 72921
Phone: (479) 632-3813
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CEDAR RIDGE, INC is a residential treatment facility, intellectual and/or developmental disabilities in Alma, AR. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. CEDAR RIDGE, INC NPI is 1184848202. The provider is registered as an organization entity type.

The provider's business location address is:

107 THICKSTEN DR
ALMA, AR
ZIP 72921
Phone: (479) 632-3813
Fax: (479) 632-8986

The provider's authorized official is Toni D Wilson .
The authorized official title is Executive Director and has the following contact phone number (479) 632-3813.

The CLIA number assigned to this NPI record is 04D2074939 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/12/2007 and was last updated on 8/22/2020.


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
1320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities04-G030ARKANSASYes

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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