NPIMap

Organization Active NPI

Centers for Youth and Families, Inc

  • Adolescent and Children Mental Health Clinic/Center
  • Monticello, AR
National Provider Identifier
1982189478
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
CENTERS FOR YOUTH AND FAMILIES, INC
Practice address
936 Jordan Dr
Monticello, AR 71655-5728
Phone
(870) 460-0066
Fax
(870) 460-0185
NPI assigned
Oct 1, 2018
Last updated
Oct 1, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTERS FOR YOUTH AND FAMILIESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Authorized official

Name
Barbara McCrory, CPA
Title
Chief Financial Officer
Phone
(501) 660-6886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

936 Jordan Dr
Monticello, AR 71655-5728

Mailing address

5800 W 10TH St
Little Rock, AR 72204-1752
Phone (501) 666-8686

Other names 1

  • Southeast Outpatient Center Other name

Medicare participation

Medicare enrollment files
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 1982189478. Details of each certification follow.

  • CCN 04L118 Psychiatric residential treatment facility · Active · Name & address match · Details

Psychiatric residential treatment facility certification: CCN 04L118

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
THE CENTERS FOR YOUTH AND FAMILIES (MONTICELLO)
Certification status
Active
Provider type (POS)
Psychiatric residential treatment facility
Participating since
Jul 20, 2011
Last certification
Oct 7, 2021
Beds
23
Ownership / control type
For profit – individual
Facility address
936 Jordan Drive
Monticello, AR 71655

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2056378Centers for Youth & Families, the936 Jordan Drive, Monticello, AR 71655Certificate of waiverMar 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Centers for Youth and F17 organizations share this tax ID, including this one
Part of
Centers for Youth and F

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1982189478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 W 10TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041752",
            "telephone_number": "501-666-8686",
            "fax_number": "501-660-6830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 JORDAN DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716555728",
            "telephone_number": "870-460-0066",
            "fax_number": "870-460-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERS FOR YOUTH AND FAMILIES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTERS FOR YOUTH AND FAMILIES",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "MCCRORY",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "501-660-6886",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast Outpatient Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Monticello, AR

Sources for this page

Verify at the official NPI Registry.