OrganizationActive
5 Residential LLC
NPI 1104398460 · Children's Substance Abuse Rehabilitation Facility · Jonesboro, AR
Provider details
- NPI number
- 1104398460
- Entity type
- Organization
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Authorized official
- Beau Eaves, Cfo
Practice location
2209 Grant Ave Ste a
Jonesboro, AR 72401-6195
Phone: (870) 333-5300
Fax: (870) 333-5301
Mailing address
2209 Grant Ave Ste a
Jonesboro, AR 72401-6195
Registry dates
- Enumerated
- 2018-12-27
- Last updated
- 2018-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.