5 RESIDENTIAL LLC – NPI #1104398460
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 children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included.

Health Care Provider Taxonomy Code for Substance Abuse Rehabilitation Facility

5 RESIDENTIAL LLC is a substance abuse rehabilitation facility located in JONESBORO, AR. NPPES has assigned the NPI number 1104398460 to 5 RESIDENTIAL LLC on December 27, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. This provider is also associated with 2 additional names listed below. The primary taxonomy selected by this provider is 3245S0500X from the Health Care Provider Taxonomy code set, which is classified as Substance Abuse Rehabilitation Facility, specializing in Substance Abuse Treatment, Children

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 5 RESIDENTIAL LLC below.

NPI Profile for
5 RESIDENTIAL LLC

NPI Number
1104398460
Enumeration Date

(more than 7 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
5 RESIDENTIAL LLC
Other name(s)
All associated names:
Doing Business As (dba)
5 res detox
Former Legal Business Name
5 Res Detox LLC
Primary location
2209 GRANT AVE STE A
JONESBORO, AR 72401-6195
Phone: (870) 333-5300 Fax: (870) 333-5301
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BEAU EAVES
CFO
Phone: (870) 273-2096
Updated
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
3245S0500X
- Substance Abuse Rehabilitation Facility / Substance Abuse Treatment, Children (Primary)

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.