Organization
YOUNG HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULA LEANN STONER (CREDENTIALING SPECIALIST)
(479) 967-2322
Entity
Organization
Contact information
Practice address
910 NORTH ITHACA AVE, RUSSELLVILLE, AR 72801-4301
(479) 967-2322
Mailing address
PO BOX 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
(479) 763-3308
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
444
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109360213
—
AR
Enumeration date
05/07/2007
Last updated
01/14/2026
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