D & K Harbick Five LLC

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

Legal business name

D & K HARBICK FIVE LLC

Doing business as

Ark77 Recovery Center

Practice address

91804 Mill Creek Rd
Blue River, OR 97413-9711

Phone

(541) 822-3603

NPI assigned

Dec 29, 2017

Last updated

Dec 29, 2017By 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

Kail L Harbickq

Title

Owner

Phone

(541) 822-3603

Specialties & licenses 3

Addresses

Other names 1

• Ark77 Recovery Center Doing business as

Locations

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514505600000",
    "number": "1235646266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91804 MILL CREEK RD",
            "city": "BLUE RIVER",
            "state": "OR",
            "postal_code": "974139711",
            "telephone_number": "541-822-3603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91804 MILL CREEK RD",
            "city": "BLUE RIVER",
            "state": "OR",
            "postal_code": "974139711",
            "telephone_number": "541-822-3603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D & K HARBICK FIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-29",
        "last_updated": "2017-12-29",
        "status": "A",
        "authorized_official_last_name": "HARBICKQ",
        "authorized_official_first_name": "KAIL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-822-3603"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ark77 Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Loree Cramer, FNP-C
• Daisy Cruz, CHW
• Andrea Ruth Lowry, LPN
• Kristi Ann McKenzie, LCSW
• Debra M Waddell, FNP-C
• Leslie West, FNP
• Nessa Marie Wilson, LCSW

• Mental Illness Community Based Residential Treatment Facility in Blue River, OR
• Providers in Blue River, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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.