TEXARKANA BEHAVIORAL ASOCIATES LC (NPI# 1316071228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316071228 |
| Entity Type | Organization |
| Organization Name | TEXARKANA BEHAVIORAL ASOCIATES LC |
| Other Organization Name | VISTA HEALTH FORT SMITH |
| Practice Address |
10301 Mayo Dr Barling AR 72923-1660 |
| Mailing Address |
4253 N Crossover Rd Fayetteville AR 72703-4593 |
| Practice Telephone | 4794945700 |
| Practice Fax Number | 4794848142 |
| Mailing Telephone | 4795215731 |
| Mailing Fax Number | 4795214926 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CONNIE M BORRENGASSER (CEO) |
| Authorized Official Telephone | 4795215731 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | AR4151 | AR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 2000112010C | 05 |
| Other Name | Type Code |
|---|---|
| VISTA HEALTH FORT SMITH | Doing Business As Name - Organization |
| Street Address |
10301 MAYO DR |
| City | BARLING |
| State | AR |
| Zip Code | 72923-1660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326034547 | Terrell P Bishop | Psychiatry & Neurology | 10301 Mayo Dr, Barling, AR 72923-1660 | 2005-09-22 |
| 1124630223 | Alexandra Tiffany Essid | Nurse Practitioner | 10301 Mayo Dr, Barling, AR 72923-1660 | 2020-08-19 |
| 1750942215 | Kelley Danielle Hale | Nurse Practitioner | 10301 Mayo Dr, Barling, AR 72923-1660 | 2019-06-25 |
| 1740762905 | Kally Marie Elizabeth Sivage | Nurse Practitioner | 10301 Mayo Dr, Barling, AR 72923-1660 | 2018-09-04 |
| 1154707461 | Valley Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 10301 Mayo Dr, Barling, AR 72923-1660 | 2015-08-10 |
| 1629478946 | Lisa G Brock | Counselor | 10301 Mayo Dr, Barling, AR 72923-1660 | 2014-08-25 |
| 1124466701 | Phomakay Primary Care Pa | Family Medicine | 10301 Mayo Dr, Barling, AR 72923-1660 | 2013-06-05 |
| 1154674661 | Saige E Small | Case Manager/Care Coordinator | 10301 Mayo Dr, Barling, AR 72923-1660 | 2012-10-22 |
| 1811242233 | Savannah Keeter | Case Manager/Care Coordinator | 10301 Mayo Dr, Barling, AR 72923-1660 | 2012-07-23 |
| 1922369495 | James Vitale | Case Manager/Care Coordinator | 10301 Mayo Dr, Barling, AR 72923-1660 | 2012-05-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831702182 | Marshall Sebastian Parker | Chiropractor | 7209 Chad Colley Blvd, Suite A, Barling, AR 72923 | 2020-08-26 |
| 1912568304 | Community Family Medical Clinic, LLC. | Family Medicine | 1202 Fort Street, Barling, AR 72923 | 2019-06-26 |
| 1548718125 | Chandra Mathis | Nurse Practitioner | 1200 Fort St, Barling, AR 72923 | 2016-09-13 |
| 1982961439 | Valley Behavioral Health System LLC | Psychiatric Hospital | 10301 Mayo Drive, Barling, AR 72923 | 2012-04-20 |
| 1013162031 | Dana Smith | Case Manager/Care Coordinator | 1311 Fort Street, Ste J, Barling, AR 72923 | 2008-11-18 |
| 1861643116 | Peter Nguyen | Case Manager/Care Coordinator | 1311 Fort Smith, Barling, AR 72923 | 2008-10-06 |
| 1346464120 | Alert Response, LLC | Durable Medical Equipment & Medical Supplies | 618 Fort Street, Bartling, AR 72923 | 2007-04-12 |
| 1043346752 | Jenny Burton | Case Manager/Care Coordinator | 1311 Fort St., Suite J, Barling, AR 72923 | 2007-02-26 |
| 1922142454 | Edward R Obana Jr. | Social Worker | 1311 Fort Street, Suite J, Barling, AR 72923 | 2007-02-17 |
| 1730198110 | Health Depot Pharmacies, LLC | Durable Medical Equipment & Medical Supplies | 1610 Fort Street, Barling, AR 72923 | 2006-08-05 |
| Find all providers in zip 72923 | ||||
| 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 |
|---|---|---|---|---|
| 1154707461 | Valley Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 10301 Mayo Dr, Barling, AR 72923-1660 | 2015-08-10 |
| 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 |
| 1447380423 | Piney Ridge Treatment Center, LLC | Psychiatric Residential Treatment Facility | 4253 Crossover Rd, Fayetteville, AR 72703 | 2007-03-07 |
| 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 |
| 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 |
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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.