Healthcare Provider Details
I. General information
NPI: 1447380423
Provider Name (Legal Business Name): PINEY RIDGE TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2007
Last Update Date: 03/14/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2601 HABBERTON ROAD
SPRINGDALE AR
72764
US
IV. Provider business mailing address
6100 TOWER CIR STE 1000
FRANKLIN TN
37067-1509
US
V. Phone/Fax
- Phone: 479-587-1408
- Fax:
- Phone: 615-861-6000
- Fax: 615-261-9685
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 323P00000X |
| Taxonomy | Psychiatric Residential Treatment Facility |
| License Number | |
| License Number State | AR |
VIII. Authorized Official
Name: MR.
BRIAN
P.
FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-861-6000