SOUTHSIDE CSB


Address: 143 Industrial Pkwy, Clarksville, VA 23927
Phone: 4345726916

SOUTHSIDE CSB (NPI# 1730485905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1730485905
Entity Type Organization
Organization Name SOUTHSIDE CSB
Practice Address 143 Industrial Pkwy
Clarksville
VA 23927
Mailing Address Po Box 1478
143 Industrial Parkway
Clarksville
VA 23927-1478
Practice Telephone 4345726916
Practice Fax Number 4343743321
Mailing Telephone 4345726916
Mailing Fax Number 4343743321
Enumeration Date 2011-02-04
Last Update Date 2017-03-22
Authorized Official Name ELIZABETH C ENGELHORN (EXECUTIVE DIRECTOR)
Authorized Official Telephone 4345726916
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 315P00000X Intermediate Care Facility, Mentally Retarded Nursing & Custodial Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1912252958 Southside Csb Intermediate Care Facility, Mentally Retarded 143 Industrial Pky, Clarksville, VA 23927 2012-07-16

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities SOUTHSIDE CSB 143 Industrial Parkway, Clarksville, VA 23927-3140

Office Location

Street Address 143 INDUSTRIAL PKWY
City CLARKSVILLE
State VA
Zip Code 23927

Providers in the same location

NPI Name Taxonomy Address Enumeration
1992354476 Megan Jean Zamora Nurse Practitioner 143 Industrial Pkwy, Clarksville, VA 23927-3140 2019-09-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1912252958 Southside Csb Intermediate Care Facility, Mentally Retarded 143 Industrial Pky, Clarksville, VA 23927 2012-07-16
1346306859 Reginald S Young Dentist 611 Virginia Avenue, Clarksville, VA 23927 2006-12-29
1083792261 Clarksville Counseling Center, Plc Counselor 403 Virginia Avenue, Suite F, Clarksville, VA 23927 2006-11-02
1396830956 Sabrina Bullock Midwife 606 Virginia Avenue, Clarksville, VA 23927 2006-10-03
1831282946 Food Lion LLC Durable Medical Equipment & Medical Supplies 1013 Virginia Ave, Clarksville, VA 23927 2006-10-02
1669572897 Dominion Health Medical Assoc Legal Medicine 115 College St, Clarksville, VA 23927 2006-09-25
1255350807 Clarksville Community Pharmacy, Inc. Pharmacist 11226 Hwy. 15 S., Clarksville, VA 23927 2006-07-18
1619974029 Clarksville Senior Care, LLC Skilled Nursing Facility 184 Buffalo Rd, Clarksville, VA 23927 2005-06-30
1861755746 Rachael Burton Family Medicine 115 College St, Clarksville, VA 23927 2012-06-16
1518915651 Clarksville Senior Care, LLC Durable Medical Equipment & Medical Supplies 184 Buffalo Rd, Clarksville, VA 23927 2006-05-04
Find all providers in zip 23927

Taxonomy Information

Taxonomy Code 315P00000X
Grouping Nursing & Custodial Care Facilities
Classification Intermediate Care Facility, Mentally Retarded

Taxonomy Definition

(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).

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1912252958 Southside Csb Intermediate Care Facility, Mentally Retarded 143 Industrial Pky, Clarksville, VA 23927 2012-07-16

Providers in the same taxonomy and state

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
Find all providers with the same taxonomy

Competitor

Search similar providers

City CLARKSVILLE
Zip Code 23927

Improve Information

Please comment or provide details below to improve the information on SOUTHSIDE CSB.

Dataset Information

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.

Trending Searches