Provider Demographics
NPI:1891532768
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: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:870-802-7100
Mailing Address - Street 1:PO BOX 16720
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6711
Mailing Address - Country:US
Mailing Address - Phone:870-802-7100
Mailing Address - Fax:
Practice Address - Street 1:2401 FOX MEADOW LN
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-7664
Practice Address - Country:US
Practice Address - Phone:870-802-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Multi-Specialty