Provider Demographics
NPI:1275299786
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 STE 102
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 STE 102
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:CROWLEYS RIDGE DEVELOPMENT COUNCIL, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-10
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251B00000XAgenciesCase Management