GREAT RIVER RESIDENTIAL ACADEMY (AMERIS OF ARKANSAS, LLC) NPI 1104033976

Psychiatric Residential Treatment Facility in Osceola, AR

NPI 1104033976 Organization Psychiatric Residential Treatment Facili...

About GREAT RIVER RESIDENTIAL ACADEMY (AMERIS OF ARKANSAS, LLC)

Great River Residential Academy (ameris Of Arkansas, Llc) is a provider established in Osceola, Arkansas specializing in psychiatric residential treatment facility. The NPI number of Great River Residential Academy (ameris Of Arkansas, Llc) is 1104033976 and was assigned on May 2007. The practitioner's primary taxonomy code is 323P00000X with license number 20102 (AR). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Great River Residential Academy. The authorized official of this NPI record is Luther Ramsay (Vice President)

NPI

1104033976

Provider NameGREAT RIVER RESIDENTIAL ACADEMY (AMERIS OF ARKANSAS, LLC)
Provider Location Address611 W LEE AVE OSCEOLA, AR 72370
Provider Mailing Address1114 17TH AVE S NASHVILLE, TN 37212
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameGREAT RIVER RESIDENTIAL ACADEMY
Other Name TypeDoing Business As (3)
Enumeration Date05-17-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code323P00000X
ClassificationPsychiatric Residential Treatment Facility
TypeResidential Treatment Facilities
License No.20102
License StateAR
Taxonomy DescriptionA residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary

Business Address

GREAT RIVER RESIDENTIAL ACADEMY
611 W LEE AVE
OSCEOLA, AR
ZIP 72370
Phone: (870) 563-7000
Fax: (870) 838-7493

Get Directions


Mailing Address

GREAT RIVER RESIDENTIAL ACADEMY
1114 17TH AVE S
NASHVILLE, TN
ZIP 37212
Phone: (615) 327-4440
Fax: (615) 327-0898



Authorized Official

Authorized Official Name LUTHER RAMSAY
Authorized Official TitleVICE PRESIDENT
Authorized Official Phone(615) 327-4440

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
BEING APPLIED FORMEDICAID (05)AR

Other Providers at the same location


The following 8 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1801878897MR. RAYMOND SCOTT FERGUS MD
Individual
Surgery611 W LEE AVE
OSCEOLA, AR 72370
(870) 563-7180
1013088848SMC REGIONAL MEDICAL CENTER
Organization
General Acute Care Hospital (Critical Access)611 W LEE AVE
OSCEOLA, AR 72370
(871) 838-7213
1952544389MISSISSIPPI COUNTY HOSPITAL SYSTEM
Organization
General Acute Care Hospital (Critical Access)611 W LEE AVE
OSCEOLA, AR 72370
(870) 838-7445
1871872846WEST LEE EMERGENCY PHYSICIANS
Organization
Emergency Medicine611 W LEE AVE
OSCEOLA, AR 72370
(870) 563-7000
1366685992SMC-MISSISSIPPI COUNTY HOSPITAL SYSTEM
Organization
General Acute Care Hospital (Critical Access)611 W LEE AVE
OSCEOLA, AR 72370
(870) 838-7000
1225025646AMERIS OF OSCEOLA LLC
Organization
General Acute Care Hospital (Critical Access)611 W LEE AVE
OSCEOLA, AR 72370
(870) 563-7000
1003970872AMERIS OF OSCEOLA,LLC
Organization
Medicare Defined Swing Bed Unit611 W LEE AVE
OSCEOLA, AR 72370
(870) 563-7200
1043553860EAST ARKANSAS EMERGENCY PHYSICIANS, PLLC
Organization
Emergency Medicine611 W LEE AVE
OSCEOLA, AR 72370
(870) 563-7000

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.