Provider Demographics
NPI:1114365988
Name:CROWLEY'S RIDGE DEVELOPMENT COUNCIL, INC.
Entity Type:Organization
Organization Name:CROWLEY'S RIDGE DEVELOPMENT COUNCIL, INC.
Other - Org Name:NORTHEAST ARKANSAS REGIONAL RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOLDRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:870-932-0228
Mailing Address - Street 1:6009 C W POST RD
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-8139
Mailing Address - Country:US
Mailing Address - Phone:870-932-0228
Mailing Address - Fax:870-910-5689
Practice Address - Street 1:6009 C W POST RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-8139
Practice Address - Country:US
Practice Address - Phone:870-932-0228
Practice Address - Fax:870-910-5689
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROWLEY'S RIDGE DEVELOPMENT COUNCIL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-13
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR00124324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility