Provider Demographics
NPI:1194425793
Name:CROWLEY'S RIDGE DEVELOPMENT COUNCIL INC.
Entity type:Organization
Organization Name:CROWLEY'S RIDGE DEVELOPMENT COUNCIL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
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:
Practice Address - Street 1:2114 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-8312
Practice Address - Country:US
Practice Address - Phone:870-932-0228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CROWLEY'S RIDGE DEVELOPMENT COUNCIL INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-03
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty