YOUTH HOME INCORPORATED (NPI# 1326232240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326232240 |
| Entity Type | Organization |
| Organization Name | YOUTH HOME INCORPORATED |
| Practice Address |
5109 W 23rd St Little Rock AR 72204-5101 |
| Practice Telephone | 5016637667 |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |
| Authorized Official Name | SCEALITA DRENNON (BEHAVIOR SPECIALIST) |
| Authorized Official Telephone | 5016637667 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
5109 W 23RD ST |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72204-5101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952966 | Shane Wilson | Non-emergency Medical Transport (VAN) | 1522 S Tyler St, Little Rock, AR 72204 | 2018-08-16 |
| 1659858348 | Poplar Grove Operations LLC | Skilled Nursing Facility | 7801 Kanis Road, Little Rock, AR 72204 | 2018-07-25 |
| 1275056004 | University of Arkansas for Medical Sciences | Orthopaedic Surgery | 108015 Colonel Glenn Rd, Little Rock, AR 72204 | 2017-07-24 |
| 1265954820 | Marilyn Marie Lynch | Registered Nurse | 7723 Colonel Glenn Road, Little Rock, AR 72204 | 2017-07-14 |
| 1962852954 | Arkansas Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1122 S. University Ave, Little Rock, AR 72204 | 2016-06-21 |
| 1841607751 | Charity Gillespie | Registered Nurse | 5210 Timberland Dr, Little Rock, AR 72204 | 2014-07-14 |
| 1043625221 | Interventional Surgery Institute of Little Rock, LLC | Clinic/Center | 9 Freeway Drive, Suite A, Little Rock, AR 72204 | 2014-06-25 |
| 1548696065 | Jamie Washington | Prosthetic/Orthotic Supplier | 4701 Westwood Ave, Little Rock, AR 72204 | 2013-09-16 |
| 1124468913 | Stephanie Rachelle Jez | Genetic Counselor, MS | 5800 West 10th Street, Freeway Medical Building, Suite 7-500, Little Rock, AR 72204 | 2013-06-26 |
| 1336492321 | Alton Charles Phillips Sr. | Counselor | 4400shuffield Drive, Little Rock, AR 72204 | 2012-10-16 |
| Find all providers in zip 72204 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326116518 | United Methodist Children's Home, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2002 S Fillmore St, Little Rock, AR 72204-4909 | 2006-12-04 |
| 1437517844 | David Zajac | Residential Treatment Facility, Emotionally Disturbed Children | 20400 Colonel Glenn Rd, Little Rock, AR 72210-5323 | 2016-02-01 |
| 1104282235 | Cedric Mayo | Residential Treatment Facility, Emotionally Disturbed Children | 20400 Colonel Glenn Rd, Little Rock, AR 72210-5323 | 2016-01-05 |
| 1477928984 | Kelanda Williams | Residential Treatment Facility, Emotionally Disturbed Children | 20400 Colonel Glenn Rd, Little Rock, AR 72210-5323 | 2015-12-09 |
| 1508231085 | Derwin Clark | Residential Treatment Facility, Emotionally Disturbed Children | 20400 Colonel Glenn Rd, Little Rock, AR 72210-5323 | 2015-12-09 |
| 1932574431 | Felicia Reynolds-johnson | Residential Treatment Facility, Emotionally Disturbed Children | 20400 Colonel Glenn Rd, Little Rock, AR 72210-5323 | 2015-12-09 |
| 1174763536 | United Methodist Children's Home | Residential Treatment Facility, Emotionally Disturbed Children | 1600 Aldersgate Rd, Suite 200, Little Rock, AR 72205-6614 | 2009-02-25 |
| 1134397276 | Centers for Youth and Families, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 6501 W 12th St, Little Rock, AR 72204-1511 | 2008-02-12 |
| 1649458514 | Centers for Youth and Families | Residential Treatment Facility, Emotionally Disturbed Children | 6501 W 12th St, Little Rock, AR 72204-1511 | 2008-02-04 |
| 1891901955 | Youth Home Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 20400 Colonel Glenn Rd, Little Rock, AR 72210-5323 | 2007-05-15 |
| Find all providers in LITTLE ROCK | ||||
| City | LITTLE ROCK |
| Zip Code | 72204 |
Please comment or provide details below to improve the information on YOUTH HOME INCORPORATED.
| 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.