JEREMIAH RECOVERY HOUSE, INC. – NPI #1366153454
Substance Abuse Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

JEREMIAH RECOVERY HOUSE, INC. is a substance abuse rehabilitation facility located in BERRYVILLE, AR. NPPES has assigned the NPI number 1366153454 to JEREMIAH RECOVERY HOUSE, INC. on December 08, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 324500000X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility.

The NPI profile was last updated on Dec 04, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JEREMIAH RECOVERY HOUSE, INC. below.

NPI Profile for
JEREMIAH RECOVERY HOUSE, INC.

NPI Number
1366153454
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JEREMIAH RECOVERY HOUSE, INC.
Primary location
706 PARK ST
BERRYVILLE, AR 72616-3134
Phone: (870) 661-2099 Fax:
1 Other location(s):
801 W Trimble Ave
Berryville, AR 72616-5101
Phone: (870) 716-9365
Mailing address
801 W TRIMBLE AVE
BERRYVILLE, AR 72616-5101
Phone: Fax:
Organization Subpart
No
Authorized Official
VICKIE POULSON
CEO
Phone: (870) 716-9365
Updated
Certification Date
Dec 04, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
324500000X
- Substance Abuse Rehabilitation Facility (Primary)
261QR0405X
- Clinic/Center / Rehabilitation, Substance Use Disorder

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.