Organization
5 RESIDENTIAL LLC
Active
Other names
5 res detox, 5 Res Detox LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BEAU HUNTER EAVES (CFO)
(870) 273-2096
Entity
Organization
Contact information
Practice address
2209 GRANT AVE STE A, JONESBORO, AR 72401-6195
(870) 333-5300
(870) 333-5301
Mailing address
2209 GRANT AVE STE A, JONESBORO, AR 72401-6195
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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