Cedar Ridge, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

04-G030 Issued in AR

Legal business name

CEDAR RIDGE, INC

Practice address

107 Thicksten Dr
Alma, AR 72921

Phone

(479) 632-3813

Fax

(479) 632-8986

NPI assigned

Apr 12, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Toni D Wilson, M.ED

Title

Executive Director

Phone

(479) 632-3813

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184848202. Details of each certification follow.

• CCN 04G030 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 04G030

Legal name

CEDAR RIDGE, INC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Sep 8, 1990

Last certification

Jun 27, 2025

Beds

10

Ownership / control type

Private (non-profit)

Facility address

107 Thicksten Drive
Alma, AR 72921

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Deborah Lynne Lovelace, LPN

  • Licensed Practical Nurse
  • Alma, AR
  • NPI 1730912056
  NPD (past)
• Laci Osman

  • Licensed Practical Nurse
  • Alma, AR
  • NPI 1508412354
  NPD (past)
• Anna Markay Roberts

  • Licensed Practical Nurse
  • Alma, AR
  • NPI 1417787227
  NPD (past)
• Teresa Ann Wagner, RN

  • Registered Nurse
  • Alma, AR
  • NPI 1508694274
  NPD (past)
• Teika Wilkins, RN

  • School Registered Nurse
  • Alma, AR
  • NPI 1548754955
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184848202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 THICKSTEN DR",
            "address_2": "P.O. BOX 2389",
            "city": "ALMA",
            "state": "AR",
            "postal_code": "72921",
            "telephone_number": "479-632-3813",
            "fax_number": "479-632-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 THICKSTEN DR",
            "city": "ALMA",
            "state": "AR",
            "postal_code": "72921",
            "telephone_number": "479-632-3813",
            "fax_number": "479-632-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RIDGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "479-632-3813",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "AR",
            "license": "04-G030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Caldwell, LPC
• Sarah Calvillo
• Douglas Eugene Carlson, D.O.
• Theresa Arena Carter
• Chance Cash
• Center for Child Development and Family Education
• Center for Child Development and Family Education
• Central Chiropractic
• Century Dental
• Chris Steven Cerna

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Alma, AR
• Providers in Alma, AR by specialty
• Intellectual and/or Developmental Disabilities 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.