ALICE C. TYLER VILLAGE OF CHILDHELP (NPI# 1083702229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083702229 |
| Entity Type | Organization |
| Organization Name | ALICE C. TYLER VILLAGE OF CHILDHELP |
| Other Organization Name | CHILDHELP |
| Practice Address |
23164 Dragoon Rd Lignum VA 22726-2036 |
| Practice Telephone | 5403991926 |
| Practice Fax Number | 5403991805 |
| Mailing Telephone | 5403991926 |
| Mailing Fax Number | 5403991805 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PATTI CONWAY (DIRECTOR OF PATIENT ACCOUNTING) |
| Authorized Official Telephone | 7032081539 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| X | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0501039000 | 05 |
| Other Name | Type Code |
|---|---|
| Childhelp | Other Name - Individual/Organization |
| Street Address |
23164 DRAGOON RD |
| City | LIGNUM |
| State | VA |
| Zip Code | 22726-2036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205447166 | Ayla Vitalia Mendez | Counselor | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2020-08-13 |
| 1053957449 | Zari Encarnacion-white | Counselor | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2019-11-21 |
| 1811472368 | Nancy C Lynn | Dietitian, Registered | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2018-10-01 |
| 1174053847 | Lindsay Jankowski | Counselor | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2017-06-15 |
| 1487084927 | Robin Long | Nurse Practitioner | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2013-11-20 |
| 1316379282 | Tracey Elaine Groux | Counselor | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2013-08-02 |
| 1407128713 | Childhelp | Residential Treatment Facility, Emotionally Disturbed Children | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2012-02-01 |
| 1295006302 | Amy Lynne Campbell | Social Worker | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2012-01-20 |
| 1013206069 | Lisa Stewart Mccarton | Social Worker | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2011-03-30 |
| 1407152465 | Amy Loveless | Psychologist | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2011-02-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245651629 | Ayo Morries | Counselor | 23248 Lignum Rd, Lignum, VA 22726-1927 | 2014-01-02 |
| 1497070072 | Cynthia A Curtis | Registered Nurse | 21478 Countryside Ln, Lignum, VA 22726-2010 | 2010-04-07 |
| 1699949677 | James A Simpson | Contractor | 23065 Sams Ridge Rd, Lignum, VA 22726-2060 | 2008-04-21 |
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407128713 | Childhelp | Residential Treatment Facility, Emotionally Disturbed Children | 23164 Dragoon Rd, Lignum, VA 22726-2036 | 2012-02-01 |
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|---|---|---|---|---|
| 1336619667 | The Discovery School of Virginia, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2697 Copper Mine Road, Dillwyn, VA 23936-2393 | 2018-11-29 |
| 1184102188 | Limitless Growth | Residential Treatment Facility, Emotionally Disturbed Children | 115 Reese Dr, Danville, VA 24540-1185 | 2018-08-01 |
| 1871099721 | Imagination LLC | Residential Treatment Facility, Emotionally Disturbed Children | 318 N Wilkinson Rd, Richmond, VA 23227-1631 | 2018-03-31 |
| 1245698935 | Summer House | Residential Treatment Facility, Emotionally Disturbed Children | 16056 Elderly Ln, Timberville, VA 22853-2922 | 2016-02-09 |
| 1194105346 | Tamara Doud | Residential Treatment Facility, Emotionally Disturbed Children | 165 Motoka Dr Apt 1, Newport News, VA 23602-4053 | 2015-06-03 |
| 1679953871 | Just Understanding My Priorities | Residential Treatment Facility, Emotionally Disturbed Children | 7109 Barry Rd, Alexandria, VA 22315-3408 | 2015-06-02 |
| 1538507983 | Alc Youth & Family Services, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 14200 Kentwood Forest Dr, Chester, VA 23831-8029 | 2013-06-07 |
| 1366790107 | Hamlet House Youth Services, IIi LLC | Residential Treatment Facility, Emotionally Disturbed Children | 206 Carlstone Dr, Highland Springs, VA 23075-2503 | 2012-08-28 |
| 1417214149 | Turning Point Home for Boys, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4701 Stonehurst Dr, Woodbridge, VA 22192-5727 | 2012-04-19 |
| 1699046094 | Intercept Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 410 Adkins Rd, North Chesterfield, VA 23236-2833 | 2012-01-18 |
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| 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.