5 Residential LLC

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

5 RESIDENTIAL LLC

Practice address

2209 Grant Ave Ste a
Jonesboro, AR 72401-6195

Phone

(870) 333-5300

Fax

(870) 333-5301

NPI assigned

Dec 27, 2018

Organization subpart

No

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

Authorized official

Name

Beau Hunter Eaves

Title

Cfo

Phone

(870) 273-2096

Specialties & licenses 1

Addresses

Other names 2

• 5 res detox Doing business as
• 5 Res Detox LLC Former legal business name

Locations

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545868800000",
    "number": "1104398460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 GRANT AVE STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 GRANT AVE STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016195",
            "telephone_number": "870-333-5300",
            "fax_number": "870-333-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5 RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A",
        "authorized_official_last_name": "EAVES",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "870-273-2096"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "5 res detox",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "5 Res Detox LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• A Better Day Resource Center
• A1 Health Solutions, LLC
• Kimberly A. Abanathy, L.P.C.
• John S Abernathy, D.D.S.
• Abilities Unlimited of Jonesboro, Inc.

• Children's Substance Abuse Rehabilitation Facility in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Children's Substance Abuse Rehabilitation Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.