COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI (NPI# 1023118437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023118437 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI |
| Other Organization Name | EASTERN STATE HOSPITAL |
| Practice Address |
4601 Ironbound Rd Williamsburg VA 23188-2652 |
| Practice Telephone | 7572535241 |
| Practice Fax Number | 7572535065 |
| Mailing Telephone | 7572535241 |
| Mailing Fax Number | 7572535065 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2015-08-26 |
| Authorized Official Name | MR. J. FRANK GALLAGHER III (HOSPITAL DIRECTOR-CEO) |
| Authorized Official Telephone | 7572535241 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Eastern State Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205936614 | Commonwealth of Virginia Department of Behavi | General Acute Care Hospital | 4601 Ironbound Rd, Williamsburg, VA 23188-2652 | 2006-09-25 |
| 1114027521 | Commonwealth of Virginia Department of Behavi | Intermediate Care Facility, Mental Illness | 4601 Ironbound Rd, Williamsburg, VA 23188-2652 | 2006-09-25 |
| 1518064922 | Commonwealth of Virginia Department of Behavi | Hospitalist | 4601 Ironbound Rd, Williamsburg, VA 23188-2652 | 2006-09-20 |
| 1346223153 | Commonwealth of Virginia Department of Behavi | Psychiatric Hospital | 4601 Ironbound Rd, Williamsburg, VA 23188-2652 | 2005-11-25 |
| Street Address |
4601 IRONBOUND RD |
| City | WILLIAMSBURG |
| State | VA |
| Zip Code | 23188-2652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861490344 | Eastern State Hospital | Pharmacy | 4601 Ironbound Rd, Pharmacy Box 8791, Williamsburg, VA 23188-2648 | 2005-07-08 |
| 1417578428 | Hannah Olson | Occupational Therapist | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2020-04-30 |
| 1366079113 | Hali Griswold | Psychologist | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2020-03-23 |
| 1851933147 | Gia Davila | Social Worker | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2019-10-08 |
| 1083263768 | Brittany Bak | Psychologist | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2019-09-05 |
| 1457913964 | Kojo Sarfo | Nurse Practitioner | 4601 Ironbound Rd, Williamsburg, VA 23188 | 2019-07-03 |
| 1982269841 | Carmen Kristina Ramos | Physical Therapy Assistant | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2019-05-07 |
| 1730744087 | Victoria Taylor-bowman | Occupational Therapy Assistant | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2019-05-02 |
| 1568959831 | William Menton | Student in an Organized Health Care Education/Training Program | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2018-04-22 |
| 1619474103 | Jeremy Matthew Schreiber | Student in an Organized Health Care Education/Training Program | 4601 Ironbound Rd, Williamsburg, VA 23188-2648 | 2018-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992287833 | Kathryn Goss Atanasov | Counselor | Farley Iop Williamsburg Place, 5477 Mooretown Road, Williamsburg, VA 23188 | 2018-09-06 |
| 1386180933 | Brittany Marie Purdy | Physical Therapist | 6425 Richmond Road, Williamsburg, VA 23188 | 2017-01-06 |
| 1770930745 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 6485 Centerville Rd, Williamsburg, VA 23188 | 2016-05-19 |
| 1073979738 | Sharon Harper | Social Worker | 4732 Longhill Road, Suite 3202, Williamsburg, VA 23188 | 2016-01-12 |
| 1710362819 | Diamond Healthcare | Social Worker | 5477 Mooretown Road, Williamsburg Place, Williamsburg, VA 23188 | 2015-07-30 |
| 1922489749 | Uc Davis Medical Center | General Acute Care Hospital | 3905 Cold Spring Rd, Williamsburg, VA 23188 | 2015-06-17 |
| 1013326214 | Deandra Smith | Developmental Therapist | 111 Bulifants Blvd Ste B, Williamsburg, VA 23188 | 2014-08-13 |
| 1255751590 | Lisa Marie Frazier | Counselor | 4345 New Town Ave. Ste. 107a, Williamsburg, VA 23188 | 2014-04-25 |
| 1972883569 | Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 7529 Richmond Rd, Williamsburg, VA 23188 | 2011-08-26 |
| 1720386816 | Harry Leon White | Pharmacist | 114 Molesey Hurst, Williamsburg, VA 23188 | 2011-03-14 |
| Find all providers in zip 23188 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497215461 | Pinnacle Community Services | Assisted Living Facility | 9001 Weems Rd, Manassas, VA 20110-4962 | 2019-03-25 |
| 1154847382 | Jeremy Scott Leach | Assisted Living Facility | 913 Bull Run, Staunton, VA 24401-1987 | 2017-08-18 |
| 1770003535 | Tiffanie Manor for Young Adults | Assisted Living Facility | 115 N Jefferson St, Richmond, VA 23220-5021 | 2017-06-22 |
| 1427588227 | Mental Wellness Residential | Assisted Living Facility | 1420 Spruce Street Extrension, Martinsville, VA 24412 | 2017-06-14 |
| 1588018071 | Arlington Voa Alr Operating, Inc. | Assisted Living Facility | 2000 5th St S, Arlington, VA 22204-1902 | 2016-04-20 |
| 1629476650 | God's Missing Angel's LLC | Assisted Living Facility | 301 Croft Xing, Chesapeake, VA 23320-7006 | 2014-12-08 |
| 1699941294 | Living Waters - Timberville | Assisted Living Facility | 379 N Main St, Timberville, VA 22853-9319 | 2008-05-02 |
| 1518133115 | Living Waters Care of Staunton | Assisted Living Facility | 403 N Coalter St, Staunton, VA 24401-3464 | 2008-05-02 |
| 1154501534 | Kidspeace National Centers of North America, Inc. | Assisted Living Facility | 5100 Leesburg Pike, Suite 302, Alexandria, VA 22302-1000 | 2007-11-14 |
| 1881813517 | Smith's Home for Adults | Assisted Living Facility | 16069 Martinsville Hwy, Axton, VA 24054-1973 | 2007-04-24 |
| Find all providers with the same taxonomy | ||||
| City | WILLIAMSBURG |
| Zip Code | 23188 |
Please comment or provide details below to improve the information on COMMONWEALTH OF VIRGINIA DEPARTMENT OF BEHAVI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.