Ameris of Arkansas, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

20102 Issued in AR

Legal business name

AMERIS OF ARKANSAS, LLC

Practice address

611 W Lee Ave
Osceola, AR 72370-3001

Phone

(870) 563-7000

Fax

(870) 838-7493

NPI assigned

May 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Luther Ramsay

Title

Vice President

Phone

(615) 327-4440

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Great River Residential Academy Doing business as

Tax ID family

Great River Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Ameris of Arkansas, LLC

  • General Acute Care Hospital
  • Blytheville, AR
  • NPI 1710042429
  NPD tax ID
• Town of Whitman

  • Land Ambulance
  • Whitman, MA
  • NPI 1699710574
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104033976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 17TH AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372122215",
            "telephone_number": "615-327-4440",
            "fax_number": "615-327-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W LEE AVE",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703001",
            "telephone_number": "870-563-7000",
            "fax_number": "870-838-7493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIS OF ARKANSAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAMSAY",
        "authorized_official_first_name": "LUTHER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-327-4440"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AR",
            "license": "20102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BEING APPLIED FOR",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great River Residential Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Access Medical Clinic Arkansas LLC
• Advancedtherapy of Northeast Arkansas,LLC
• Iris Annette Allen, MHPP
• Tim Allen
• Ameris of Osceola LLC
• Ameris of Osceola,LLC
• Lisa Austin
• Aaron Baker
• Jaressa Banks

• Psychiatric Residential Treatment Facility in Osceola, AR
• Providers in Osceola, AR by specialty
• Psychiatric Residential Treatment Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.