CREATIVE HOUSING III-MT HOLLY (NPI# 1952427569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952427569 |
| Entity Type | Organization |
| Organization Name | CREATIVE HOUSING III-MT HOLLY |
| Practice Address |
1215 Mount Holly Rd El Dorado AR 71730-4236 |
| Mailing Address |
714 W Grove St El Dorado AR 71730-4416 |
| Practice Telephone | 8708638194 |
| Practice Fax Number | 8708814600 |
| Mailing Telephone | 8708638194 |
| Mailing Fax Number | 8708814600 |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BARBARA STAGGS (BUSINESS MANAGER) |
| Authorized Official Telephone | 8708638194 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| Street Address |
1215 MOUNT HOLLY RD |
| City | EL DORADO |
| State | AR |
| Zip Code | 71730-4236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856172 | Mental Health Counseling for Individuals and Couples | Clinic/Center | 3256 West Hillsboro Suite C, El Dorado, AR 71730 | 2019-11-25 |
| 1114578168 | Candance Marie Guinn | Nurse Practitioner | 1906 W Hillsboro St Ste B, El Dorado, AR 71730 | 2019-09-20 |
| 1811460462 | Kelsie Rogers | Pharmacist | 2202 N West Ave, El Dorado, El Dorado, AR 71730 | 2019-01-07 |
| 1861925331 | Kasey Leigh Mcclain | Nurse Practitioner | 2280 E Main St, El Dorado, AR 71730 | 2017-04-11 |
| 1366989568 | Shane Morr | Marriage & Family Therapist | 704 W 5th Dr, El Dorado, AR 71730 | 2017-01-25 |
| 1376986539 | Ivory A. Kinslow, Mdpa | Optometrist | 443 W Oak St, El Dorado, AR 71730 | 2013-04-08 |
| 1134485170 | Drs Weddle and Baumsardner | Dentist | 106 West Main St. 212, El Dorado, AR 71730 | 2012-04-04 |
| 1972888923 | Lenora S Newsome | Pharmacist | 2135 North West Ave, El Dorado, AR 71730 | 2011-10-20 |
| 1730460338 | South Arkansas Pharmacy, Inc | Pharmacy | 600 South Timberlane #101, El Dorado, AR 71730 | 2011-09-09 |
| 1710273891 | Ezinne Charity Nwude | Emergency Medicine | 701 N. West Avenue, El Dorado, AR 71730 | 2011-06-27 |
| Find all providers in zip 71730 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477679074 | Creative Housing IIi-newton | Intermediate Care Facility, Mentally Retarded | 232 N Newton Ave, El Dorado, AR 71730-5422 | 2007-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831302108 | Young Homes | Intermediate Care Facility, Mentally Retarded | 910 N Ithaca Ave, Russellville, AR 72801-4301 | 2007-05-07 |
| 1659592038 | Creative Living. Inc | Intermediate Care Facility, Mentally Retarded | 350 Hubbard Rd, Conway, AR 72034-6153 | 2007-05-01 |
| 1467672162 | Perry County Day Service Center, Inc. | Intermediate Care Facility, Mentally Retarded | 115 South Pine Street, Perryville, AR 72126 | 2007-04-26 |
| 1821211871 | Omega Home,inc. | Intermediate Care Facility, Mentally Retarded | 112 East Ave. D, Hope, AR 71802-1540 | 2007-04-10 |
| 1548386600 | Brownwood Life Care Center, Inc. | Intermediate Care Facility, Mentally Retarded | 2121 Towson Ave, Fort Smith, AR 72901-5904 | 2007-03-21 |
| 1801928627 | State of Arkansas | Intermediate Care Facility, Mentally Retarded | 87 Reed Rd, Highway 116 South, Booneville, AR 72927 | 2007-03-09 |
| 1487781027 | State of Arkansas | Intermediate Care Facility, Mentally Retarded | 14701 Highway 111, Alexander, AR 72002-1742 | 2007-02-28 |
| 1851428189 | Jenkins Housing Inc | Intermediate Care Facility, Mentally Retarded | 3401 Chapel Pines Drive South, Pine Bluff, AR 71603 | 2007-02-27 |
| 1447395439 | Community Life Services, Inc. | Intermediate Care Facility, Mentally Retarded | 1509 Michael Dr, Little Rock, AR 72204-2336 | 2007-02-20 |
| 1659424901 | Housing Opportunities Addition, Inc. | Intermediate Care Facility, Mentally Retarded | 4600 County Ave, Texarkana, AR 71854-1410 | 2007-01-19 |
| 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.