Ozark Mountain Alcohol Residential Treatment, Inc,.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

00059 Issued in AR

Legal business name

OZARK MOUNTAIN ALCOHOL RESIDENTIAL TREATMENT, INC,.

Practice address

116 Snowball Dr
Gassville, AR 72635

Phone

(870) 435-6200

NPI assigned

Apr 5, 2011

Last updated

Apr 5, 2011By 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

Mrs. Darlene E Prine, CADC

Title

Executive Director

Phone

(870) 435-6200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• OMART, Inc. Other name

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1750670303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "GASSVILLE",
            "state": "AR",
            "postal_code": "726350188",
            "telephone_number": "870-435-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SNOWBALL DR",
            "city": "GASSVILLE",
            "state": "AR",
            "postal_code": "72635",
            "telephone_number": "870-435-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OZARK MOUNTAIN ALCOHOL RESIDENTIAL TREATMENT, INC,.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "PRINE",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "870-435-6200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CADC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AR",
            "license": "00059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ARKANSAS OFFICE OF ALCOHOL AND DRUG ABUSE PREVENTION",
            "identifier": "D14714",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMART, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Clifford B Marston III, DPM
• Winn Meredith, OD
• Christopher Aaron Olson, BSE, MHPP
• Letitia Olson
• Lisa Otto, MHPP
• Ponders Gassville Pharmacy
• Terry Dow Rhea Sr., LMSW
• Mollie Brooke Rowlett
• Larry Dean Twaddle
• Jessica Nacole Withrow

• Substance Abuse Rehabilitation Facility in Gassville, AR
• Providers in Gassville, AR by specialty
• Substance Abuse Rehabilitation Facility in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.