CHESTERFIELD COMMUNITY SERVICES BOARD-ICF MR GALLOWAY PLACE (NPI# 1629484514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629484514 |
| Entity Type | Organization |
| Organization Name | CHESTERFIELD COMMUNITY SERVICES BOARD-ICF MR GALLOWAY PLACE |
| Practice Address |
6801 Lucy Corr Ct Chesterfield VA 23832-6657 |
| Practice Telephone | 8047481227 |
| Practice Fax Number | 8047176659 |
| Mailing Telephone | 8047481227 |
| Mailing Fax Number | 8047176659 |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-07-11 |
| Authorized Official Name | MS. DEBORAH BURCHAM (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8047687220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 004945352 | 05 |
| Street Address |
6801 LUCY CORR CT |
| City | CHESTERFIELD |
| State | VA |
| Zip Code | 23832-6657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659379170 | Maria Angela Catolico | Psychiatry & Neurology | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2005-07-08 |
| 1306459425 | Mahala Jordan | Counselor | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2020-08-28 |
| 1467009472 | Jennifer Barnes-maddox | Physical Therapist | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-08-23 |
| 1104473644 | Lisa H Coker | Counselor | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-08-20 |
| 1093362535 | Marilyn K Chernicky | Counselor | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-08-20 |
| 1700433240 | Ashley Powers | Counselor | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-08-20 |
| 1487207650 | Jennifer R Peers | Social Worker | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-07-17 |
| 1346892643 | Parke Sterling | Counselor | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-07-16 |
| 1962054460 | Antoinette Sherman | Counselor | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-07-15 |
| 1649830860 | Carleigh Weaver | Social Worker | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2019-06-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019754 | Sandra Hill | Counselor | 6900 Mimms Dr, Chesterfield, VA 23832 | 2020-06-26 |
| 1285256222 | Robin Ratliff Jones | Counselor | 6801 Lucy Blvd., 92, Chesterfield Mental Health, Chesterfield, VA 23832 | 2020-05-13 |
| 1629616495 | Chantell Nicole Randolph | Technician | 6519 Brambleton Rd, Chesterfield, VA 23832 | 2019-12-12 |
| 1881244374 | Jessica G Black | Physical Medicine & Rehabilitation | 10300 Courthouse Rd, Chesterfield, VA 23832 | 2019-09-17 |
| 1467934828 | Lorien Wilder Lcsw LLC | Clinic/Center | 9844 Lori Road Suite 102, Chesterfield, VA 23832 | 2018-09-03 |
| 1902390933 | National Vision, Inc. | Technician/Technologist | 14609 Hancock Village Street, Chesterfield, VA 23832 | 2018-06-22 |
| 1659860245 | Kaitlyn Moore | Behavior Technician | 7807 Hampton Summit Ter, Chesterfield, VA 23832 | 2018-05-09 |
| 1205337417 | Vitalcare Family LLC | Family Medicine | 7300 Ashlake Parkway, Chesterfield, VA 23832 | 2018-02-22 |
| 1205200599 | Chippenham & Johnston-willis Hospitals, Inc. | Clinic/Center | 14720 Hancock Village Street, Chesterfield, VA 23832 | 2015-11-24 |
| 1265801823 | Village Counseling Services, LLC | Community/Behavioral Health | 7305 Hancock Village Drive, Suite 315, Chesterfield, VA 23832 | 2015-09-24 |
| Find all providers in zip 23832 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033397542 | Chesterfield Community Services Board - Icf Pine Forest | Intermediate Care Facility, Mentally Retarded | 6801 Lucy Corr Ct, Chesterfield, VA 23832-6657 | 2008-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598381758 | Mount Rogers Community Services | Intermediate Care Facility, Mentally Retarded | 56 Carroll House Ln, Hillsville, VA 24343-3648 | 2020-06-23 |
| 1871123729 | Mount Rogers Community Services | Intermediate Care Facility, Mentally Retarded | 795 Fairview Rd, Wytheville, VA 24382-4501 | 2020-01-20 |
| 1194379529 | Dignity Care Inc | Intermediate Care Facility, Mentally Retarded | 16654 Bolling Brook Ct, Woodbridge, VA 22191-4583 | 2019-07-24 |
| 1821657719 | Hampton-newport News Community Services Board | Intermediate Care Facility, Mentally Retarded | 1421 Aberdeen Rd, Hampton, VA 23666-4027 | 2019-06-13 |
| 1962069054 | Sunny Haven Residental Services | Intermediate Care Facility, Mentally Retarded | 114 Collinswood Dr, Staunton, VA 24401-1988 | 2019-05-23 |
| 1376042523 | Danville Pittsylvania Community Services | Intermediate Care Facility, Mentally Retarded | 505 Keen St, Danville, VA 24540-4657 | 2018-02-02 |
| 1588021596 | Future Alliance LLC | Intermediate Care Facility, Mentally Retarded | 6010 N Crestwood Ave, Suite C, Richmond, VA 23230-2200 | 2016-01-21 |
| 1780052217 | Danville-pittsylvania Community Services | Intermediate Care Facility, Mentally Retarded | 4769 Franklin Tpke, Danville, VA 24540-7807 | 2015-09-15 |
| 1922415934 | Community Residences, Inc. | Intermediate Care Facility, Mentally Retarded | 9332 Burke Rd, Burke, VA 22015-3373 | 2014-07-22 |
| 1891105607 | Horizon Behavioral Health | Intermediate Care Facility, Mentally Retarded | 101 Avoca Ln, Altavista, VA 24517-1154 | 2014-05-01 |
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| City | CHESTERFIELD |
| Zip Code | 23832 |
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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.