STATE OF ARKANSAS (NPI# 1386770030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386770030 |
| Entity Type | Organization |
| Organization Name | STATE OF ARKANSAS |
| Other Organization Name | JONESBORO HUMAN DEVELOPMENT CENTER |
| Practice Address |
4701 Colony Dr Jonesboro AR 72404-9317 |
| Practice Telephone | 8709324043 |
| Practice Fax Number | 8709324459 |
| Mailing Telephone | 8709324043 |
| Mailing Fax Number | 8709324459 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-06-25 |
| Authorized Official Name | MR. FORREST STEELE (SUPERINTENDENT) |
| Authorized Official Telephone | 8709324043 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 137 | AR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 109054213 | 05 |
| Other Name | Type Code |
|---|---|
| Jonesboro Human Development Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689117756 | State of Arkansas | Skilled Nursing Facility | 2401 John Ashley Drive, Building #100, North Little Rock, AR 72114 | 2016-11-22 |
| 1023236163 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Center Cir, Warren, AR 71671-3033 | 2007-04-23 |
| 1477672608 | State of Arkansas | Case Management | 5800 W 10th St Ste 300, Arkansas Dhhs, Little Rock, AR 72204-1764 | 2007-03-28 |
| 1801928627 | State of Arkansas | Intermediate Care Facility, Mentally Retarded | 87 Reed Rd, Highway 116 South, Booneville, AR 72927 | 2007-03-09 |
| 1407988355 | State of Arkansas | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Prator Drive, Arkadelphia, AR 71923 | 2007-03-09 |
| 1487781027 | State of Arkansas | Intermediate Care Facility, Mentally Retarded | 14701 Highway 111, Alexander, AR 72002-1742 | 2007-02-28 |
| 1093840282 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 150 Siebenmorgen Rd, Conway, AR 72032 | 2007-02-21 |
| 1417052895 | State of Arkansas | Skilled Nursing Facility | 1179 N. College Avenue, Fayetteville, AR 72703 | 2006-09-13 |
| 1912014192 | State of Arkansas | Home Health | # 22 Sherwood Plaza, Johnson County Health Unit, Clarksville, AR 72830-4337 | 2006-08-24 |
| 1649280694 | State of Arkansas | Home Health | 100 E 20th, Suite E & F Hempstead County Health Unit, Hope, AR 71801-8213 | 2006-08-09 |
| Street Address |
4701 COLONY DR |
| City | JONESBORO |
| State | AR |
| Zip Code | 72404-9317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740745967 | Imove, LLC | Physical Therapist | 8700 S. Caraway Rd., Apt. L2, Jonesboro, AR 72404 | 2019-02-01 |
| 1245728914 | Karina Coats | Nurse Anesthetist, Certified Registered | 2409 Skyline Pt, Jonesboro, AR 72404 | 2018-04-27 |
| 1619325263 | Kathryn Meyers | Specialist/Technologist | 1614 Latourette Ln Apt 2, Jonesboro, AR 72404 | 2016-05-24 |
| 1922476571 | Tmj and Facial Pain Center,llc | Dentist | 2600 Browns Lane, Ste B, Jonesboro, AR 72404 | 2015-09-11 |
| 1265828156 | Hd Dental, Pa Dba Smile Dental | Dentist | 6009 Highway 1 South, Jonesboro, AR 72404 | 2015-04-08 |
| 1124445358 | Tanner Wilson Jarrett | Occupational Therapy Assistant | 3114 Fox Road Suite A, Jonesboro, AR 72404 | 2014-03-26 |
| 1154759793 | Kasey Boyd | Specialist/Technologist | 1717 Hwy 163, Jonesboro, AR 72404 | 2013-10-17 |
| 1578848610 | Maria Ivonne Norman | Physical Therapist | 8700 S. Caraway Rd. Apt. L2, (the Meadows), Jonesboro, AR 72404 | 2011-10-20 |
| 1003198839 | Rachel Hollimon Golden | Speech-Language Pathologist | 4410 Harrisburg Rd., Jonesboro, AR 72404 | 2011-09-19 |
| 1225358021 | Darrell R Gann | Physical Therapy Assistant | 6040 Beaver Creek, Jonesboro, AR 72404 | 2010-06-03 |
| Find all providers in zip 72404 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518297175 | Heavenly Assisted Care, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 10555 Aspenwood Ct, Jonesboro, GA 30238 | 2010-01-05 |
| 1609045608 | Creative Growth | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 9695 Washington Cir, Jonesboro, GA 30238-6094 | 2008-02-22 |
| 1962617282 | Morning Light, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1564 S Hudson Ave, Jonesboro, LA 71251-4022 | 2007-05-11 |
| 1568686947 | Lincoln Square | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 202 South Main St, Jonesboro, IL 62952-0112 | 2007-04-13 |
| 1720322563 | Loving Touch Christian Academy, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 7130 Mount Zion Blvd, Suite 11, Jonesboro, GA 30236-2566 | 2012-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679701775 | Chucks Developemental Outreach Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2300 Ouachita 4, Stephens, AR 71764-9196 | 2009-06-26 |
| 1801024997 | D&j Early Learning&deveopmental Center Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2302 Ouachita 4, Stephens, AR 71764-9196 | 2009-06-26 |
| 1881822971 | Drews Early Learning Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1100 Rbl Estate Rd, Pine Bluff, AR 71603-9272 | 2009-06-26 |
| 1548477268 | Branmat Corporation | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4100 Heritage Dr, North Little Rock, AR 72117-2522 | 2007-05-16 |
| 1023236163 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Center Cir, Warren, AR 71671-3033 | 2007-04-23 |
| 1184848202 | Cedar Ridge, Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 107 Thicksten Dr, Alma, AR 72921 | 2007-04-12 |
| 1093840282 | State of Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 150 Siebenmorgen Rd, Conway, AR 72032 | 2007-02-21 |
| 1619911450 | Easy K Foundation, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Hc 80 Box 1130, Sage, AR 72573-9535 | 2006-06-15 |
| 1851916738 | Community Living Arrangements | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 714 W Grove St, El Dorado, AR 71730-4416 | 2020-06-16 |
| 1972638609 | Arkansas Easter Seals Arkansas | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3920 Woodland Heights Rd, Little Rock, AR 72212-2495 | 2007-02-22 |
| Find all providers with the same taxonomy | ||||
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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.