TEEN CHALLENGE RANCH OF NORTHWEST ARKANSAS (NPI# 1508259169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508259169 |
| Entity Type | Organization |
| Organization Name | TEEN CHALLENGE RANCH OF NORTHWEST ARKANSAS |
| Other Organization Name | TEEN CHALLENGE ADVENTURE RANCH |
| Practice Address |
16818 Hale Mountain Rd Morrow AR 72749-9731 |
| Mailing Address |
Po Box 20 Morrow AR 72749-0020 |
| Practice Telephone | 8882896818 |
| Mailing Telephone | 4794390279 |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2016-01-28 |
| Authorized Official Name | DARREN JAMES REYNOLDS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8882896818 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | AR | Residential Treatment Facilities | |
| N | 324500000X | Substance Abuse Rehabilitation Facility | AR | Residential Treatment Facilities | |
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
AR | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Teen Challenge Adventure Ranch | Doing Business As Name - Organization |
| Street Address |
16818 HALE MOUNTAIN RD |
| City | MORROW |
| State | AR |
| Zip Code | 72749-9731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538534961 | Mary Reynolds | Registered Nurse | 16818 Hale Mountain Rd, Morrow, AR 72749-9731 | 2015-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447541024 | Jennifer Elizabeth Grim | Counselor | 20856 Boys Home Rd., Morrow, AR 72749 | 2011-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427655208 | Love Life and Happiness Care Agency LLC | Home Health | 1115 Mount Zion Rd Ste 25, Morrow, GA 30260-2296 | 2020-10-05 |
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1871100107 | Jenni Heitkamp | In Home Supportive Care | 4909 Jessica Suzanne Dr, Morrow, OH 45152-8057 | 2020-09-30 |
| 1376150797 | Calandra A Gamble | Home Health | 1115 Mount Zion Rd Ste 18a, Morrow, GA 30260-2275 | 2020-09-29 |
| 1407463383 | Aurora Uwase | Home Health Aide | 6437 Wood Cir W, Morrow, GA 30260-1732 | 2020-09-25 |
| 1306451265 | Chrystal Care | Clinic/Center | 3206 Stratford Cir, Morrow, GA 30260-8111 | 2020-09-08 |
| 1760095665 | Kiah Hickman | Driver | 904 Baywood Cir, Morrow, GA 30260-2190 | 2020-08-28 |
| 1629694120 | Clayton County Juvenile Justice Fund | Social Worker | 1412 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2020-06-19 |
| 1386268944 | Shannon La'toya Burns-darden | Counselor | 5323 Creekview Way, Morrow, GA 30260-4218 | 2020-05-29 |
| 1699308742 | Rashida Nicole Biera | Behavioral Analyst | 1311 Mount Zion Rd, Morrow, GA 30260-2325 | 2020-02-18 |
| Find all providers in MORROW | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710445770 | Socal Detox, LLC | Substance Abuse Rehabilitation Facility | 1101 Sw Coventry Blvd, Bentonville, AR 72712-4325 | 2019-03-08 |
| 1104398460 | 5 Residential LLC | Substance Abuse Rehabilitation Facility | 2209 Grant Ave Ste A, Jonesboro, AR 72401-6195 | 2018-12-27 |
| 1992941363 | Rejuvenation | Substance Abuse Rehabilitation Facility | 154 Huntsville Rd, Eureka Springs, AR 72632-9730 | 2009-01-06 |
| 1528274552 | Capstone Treatment Center | Substance Abuse Rehabilitation Facility | 120 Meghan Ln, Judsonia, AR 72081-9302 | 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.