HABILITATION CENTER, LLC (NPI# 1932746070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932746070 |
| Entity Type | Organization |
| Organization Name | HABILITATION CENTER, LLC |
| Practice Address |
161 Skunk Hollow Road Conway AR 72032 |
| Mailing Address |
6100 Tower Cir Ste 1000 Franklin TN 37067-1509 |
| Practice Telephone | 8703528203 |
| Mailing Telephone | 6158617566 |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |
| Authorized Official Name | CHRISTOPHER HOWARD (EVP & GENERAL COUNSEL) |
| Authorized Official Telephone | 6158616000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Little Creek Behavioral Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952482036 | Habilitation Center, LLC | Intermediate Care Facility, Mentally Retarded | 1828 Industrial Dr, Fordyce, AR 71742 | 2006-10-17 |
| Street Address |
161 SKUNK HOLLOW ROAD |
| City | CONWAY |
| State | AR |
| Zip Code | 72032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730789843 | Amelia S Lasater | Pharmacist | 1155 Hwy 65n, Conway, AR 72032 | 2020-10-28 |
| 1619584604 | Danyelle Durocher | Occupational Therapist | 1301 North Museum Rd, Conway, AR 72032 | 2020-09-24 |
| 1780222174 | Eric Herman Boxnick | Pharmacist | 101 West Oak Street, Conway, AR 72032 | 2019-12-16 |
| 1679051668 | Mary Elizabeth Black | Nurse Practitioner | 222 Dave Ward Drive, Conway, AR 72032 | 2018-08-01 |
| 1275035602 | Conway Dental Center Pllc | Dentist | 1600 E. Oak Street Suite B, Conway, AR 72032 | 2018-03-01 |
| 1750821625 | Luke Osborne | Physical Therapy Assistant | 1 Thomas Ln, Conway, AR 72032 | 2017-02-27 |
| 1639620099 | Sam's West, Inc. | Technician/Technologist | 1250 South Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1922559343 | Sam's West, Inc. | Durable Medical Equipment & Medical Supplies | 1250 Sourth Amity Rd, Conway, AR 72032 | 2016-10-20 |
| 1639629108 | Posture Store | Durable Medical Equipment & Medical Supplies | 3900 Dave Ward Dr., Suite 1900-130, Conway, AR 72032 | 2016-10-09 |
| 1285005140 | Conway Community Services | General Acute Care Hospital | 1555 Exchange Avenue, Conway, AR 72032 | 2015-10-16 |
| Find all providers in zip 72032 | ||||
| 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 |
|---|---|---|---|---|
| 1194826081 | Hhc South Carolina Inc | Psychiatric Residential Treatment Facility | 152 Waccamaw Medical Park Dr, Conway, SC 29526-8901 | 2006-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1154707461 | Valley Behavioral Health System, LLC | Psychiatric Residential Treatment Facility | 10301 Mayo Dr, Barling, AR 72923-1660 | 2015-08-10 |
| 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 |
| 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.