DISTRICT 19 COMMUNITY SERVICES BOARD (NPI# 1790113280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790113280 |
| Entity Type | Organization |
| Organization Name | DISTRICT 19 COMMUNITY SERVICES BOARD |
| Practice Address |
232 Coppahaunk Ave Waverly VA 23890-5041 |
| Mailing Address |
20 W Bank St Petersburg VA 23803-3279 |
| Practice Telephone | 8048342205 |
| Practice Fax Number | 8048342625 |
| Mailing Telephone | 8048628002 |
| Mailing Fax Number | 8048631665 |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2013-10-22 |
| Authorized Official Name | MR. JOSEPH E HUBBARD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8048628002 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669791984 | District 19 Community Services Board | Nursing Care | 502 Sadler Dr, Emporia, VA 23847 | 2010-05-26 |
| 1679510226 | District 19 Community Services Board | Public Health or Welfare | 5012 Selwood Rd, Richmond, VA 23234-4246 | 2006-06-01 |
| 1225094451 | District 19 Community Services Board | Early Intervention Provider Agency | 20 W Bank St, Suite 2, Petersburg, VA 23803-3279 | 2006-04-25 |
| 1669970646 | District 19 Community Services Board | Early Intervention Provider Agency | 20 W Bank St Ste 5, Petersburg, VA 23803-3279 | 2018-01-25 |
| 1194760462 | District 19 Community Services Board | Social Worker | 215 W Atlantic St, Emporia, VA 23847-1223 | 2006-06-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DISTRICT 19 COMMUNITY SERVICES BOARD | 20 West Bank Street Ste 2, Petersburg, VA 23803-3279 |
| Street Address |
232 COPPAHAUNK AVE |
| City | WAVERLY |
| State | VA |
| Zip Code | 23890-5041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750312591 | Regina Francine Smith | Social Worker | 232 Coppahaunk Ave, Waverly, VA 23890 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053538421 | Horizon Health Services Inc | Clinic/Center | 344 West Main Street, Waverly, VA 23890 | 2007-04-19 |
| 1487961447 | Waverly Rescue Squad, Inc | Ambulance | 115 Bank Street, Waverly, VA 23890 | 2010-09-10 |
| 1407089592 | Waverly Volunteer Rescue Squad | Ambulance | 115 Bank St, Waverly, VA 23890 | 2009-08-24 |
| 1174683619 | Jillian Grizzard Fajna | Pharmacist | 328 W Main St, Waverly Drugs, Waverly, VA 23890 | 2006-12-12 |
| 1972607356 | Alvin Bradley | Pharmacist | 328 W Main St, Waverly, VA 23890 | 2006-09-07 |
| 1013407659 | Full Focus Training Center LLC | Community/Behavioral Health | 744 West Main Street, Waverly, VA 23890-0213 | 2018-05-17 |
| 1114096542 | Talmage Thomas Musgrove IIi | Pharmacist | 328 W Main St, Waverly, VA 23890-0596 | 2006-11-07 |
| 1053390906 | George Coleman | Family Medicine | 344 W Main St, Waverly, VA 23890-3235 | 2006-01-10 |
| 1497302350 | Back Home Pharmacy Inc | Pharmacy | 328 W Main St, Waverly, VA 23890-3235 | 2019-08-23 |
| 1801386339 | Spring Branch Rx LLC | Pharmacy | 328 W Main St, Waverly, VA 23890-3235 | 2018-05-10 |
| Find all providers in zip 23890 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225514540 | North Iowa Counseling, LLC | Community/Behavioral Health | 506 E Bremer Ave, Waverly, IA 50677 | 2018-07-19 |
| 1013407659 | Full Focus Training Center LLC | Community/Behavioral Health | 744 West Main Street, Waverly, VA 23890-0213 | 2018-05-17 |
| 1205990223 | The Larrabee Center, In.c | Community/Behavioral Health | 117 11th St Nw, Waverly, IA 50677-2212 | 2006-12-21 |
| 1114950979 | Pathways Behavioral Services Inc | Community/Behavioral Health | 111 10th St Sw, Waverly, IA 50677-2925 | 2006-07-07 |
| 1588295695 | Center for Foundational & Relational Wellness LLC | Community/Behavioral Health | 2022 3rd Ave Nw, Waverly, IA 50677-2010 | 2020-01-28 |
| 1831413921 | New Beginnings At Waverly, LLC | Community/Behavioral Health | 109 N Shore Dr, Waverly, MN 55390-5517 | 2010-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637218 | Endurance Cousneling and Supervision Services,llc | Community/Behavioral Health | 324 Lynnhaven Dr, Hampton, VA 23666-2300 | 2020-10-20 |
| 1861090615 | Energy for Life, LLC | Community/Behavioral Health | 2600 Brownstone Cir, Williamsburg, VA 23185-8321 | 2020-10-14 |
| 1093313868 | Tri Counties Behavioral Health Services, LLC | Community/Behavioral Health | 1807 Piney Woods Road, Lawrenceville, VA 23868 | 2020-10-14 |
| 1275140626 | Savoy Wellness Center LLC | Community/Behavioral Health | 1209 N 32nd St, Richmond, VA 23223-6711 | 2020-09-29 |
| 1700493582 | Therapeutic Services of Virginia | Community/Behavioral Health | 101 Deep Creek Rd, Newport News, VA 23606-2219 | 2020-09-25 |
| 1801402995 | Strategic Therapy Associates, Inc. | Community/Behavioral Health | 150 W Main St Ste E, Wytheville, VA 24382-2376 | 2020-09-23 |
| 1396351193 | Maxim Healthcare Services Inc. | Community/Behavioral Health | 293 Independence Blvd Ste 400, Virginia Beach, VA 23462-5461 | 2020-09-17 |
| 1083228902 | Lr Counseling Services, LLC | Community/Behavioral Health | 5000 Owens Way, Apt. 622, Prince George, VA 23875 | 2020-09-08 |
| 1073127411 | Youth Outreach Services | Community/Behavioral Health | 7050 Lakota Dr Apt 301, Woodbridge, VA 22192-5392 | 2020-09-02 |
| 1053924803 | Foundation of Hope Mental Health Services LLC | Community/Behavioral Health | 857 Hardwood Dr, Chesapeake, VA 23320-9215 | 2020-08-30 |
| Find all providers with the same taxonomy | ||||
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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.