SECOND NATURE BLUE RIDGE (NPI# 1871706382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871706382 |
Entity Type | Organization |
Organization Name | SECOND NATURE BLUE RIDGE |
Practice Address |
236 File Street Clayton GA 30525-3023 |
Practice Telephone | 7062122037 |
Practice Fax Number | 7062120354 |
Mailing Telephone | 7062122037 |
Mailing Fax Number | 7062120354 |
Enumeration Date | 2007-05-08 |
Last Update Date | 2012-05-29 |
Authorized Official Name | ANGIE EVANS (BUSINESS OFFICE) |
Authorized Official Telephone | 8017666604 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 50017 | GA | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | STATE LICENSE NUMBER | 50017 | 01 |
Street Address |
236 FILE STREET |
City | CLAYTON |
State | GA |
Zip Code | 30525-3023 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710218805 | Anthony Issenmann | Marriage & Family Therapist | 236 File Street, Clayton, GA 30525 | 2010-01-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528605839 | Charlotte Hart Fandrich | Massage Therapist | 1048 Old Highway 441 North, Clayton, GA 30525 | 2019-12-05 |
1922577147 | Suzanne A Frederickson | Speech-Language Pathologist | Highlands Internal Medicine, PC, 156 North Main St, Clayton, GA 30525 | 2018-11-16 |
1427562750 | Second Nature Blue Ridge, LLC | Psychiatric Residential Treatment Facility | 236 File St., Clayton, GA 30525 | 2017-11-22 |
1053854752 | Haley Vaughan Stapleton | Nurse Practitioner | 596 Mountain City Road, Clayton, GA 30525 | 2016-11-29 |
1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
1316239122 | Jason A Bonner | Pharmacist | 1455 U.S. 441, Clayton, GA 30525 | 2011-05-11 |
1477842557 | Clayton Therapy Center, LLC | Marriage & Family Therapist | 24 Chechero St, Suite 2, Clayton, GA 30525 | 2011-03-29 |
1891959672 | Adams Hearing Aid Specialists | Hearing Instrument Specialist | 91 E Savannah Place, Clayton, GA 30525 | 2008-07-11 |
1578721494 | Lawrence M Gillespie | Dentist | 436 Warwoman Road, Clayton, GA 30525 | 2008-05-28 |
1336262112 | Clayton Family Eye Care PC | Optometrist | 50 Earl St., Suite A, Clayton, GA 30525 | 2007-04-09 |
Find all providers in zip 30525 |
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 |
---|---|---|---|---|
1568611440 | Gifted Visions LLC | Residential Treatment Facility, Emotionally Disturbed Children | 148 Carrie Dr, Clayton, NC 27527-5731 | 2008-09-16 |
1518084227 | Kmg Holdings, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2016 Fort Dr, Clayton, NC 27520-9491 | 2007-03-26 |
1467579490 | Kmg Holdings, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 956 N O'neil Street, Clayton, NC 27520-6457 | 2007-03-23 |
1255791919 | House of Hope of Nc | Residential Treatment Facility, Emotionally Disturbed Children | 408 Covered Bridge Rd, Clayton, NC 27520-6559 | 2016-02-24 |
1629113170 | Rose of Sharon Adolescent Treatment Home II | Residential Treatment Facility, Emotionally Disturbed Children | 2885 Bennington Dr, Clayton, NC 27520-5971 | 2007-02-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023543766 | One Heart and One Mind Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5737 Old National Hwy, Suite 300, Atlanta, GA 30349-7410 | 2017-05-01 |
1396131249 | There's No Place Like A Loving Home LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Jardin Ct, Alpharetta, GA 30022-4600 | 2015-04-07 |
1912343302 | Our Spot | Residential Treatment Facility, Emotionally Disturbed Children | 1015 E Inman St, Statesboro, GA 30458-2049 | 2013-05-13 |
1902163520 | Shepherd's Hill Academy, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 2200 Price Rd, Martin, GA 30557-3457 | 2012-04-20 |
1871879312 | Vision Youth Services Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 4228 Redan Rd, Stone Mountain, GA 30083-5040 | 2011-10-28 |
1356634034 | Soaring Eagle Children's Group | Residential Treatment Facility, Emotionally Disturbed Children | 3183 Northbrook Dr, Atlanta, GA 30341-4629 | 2011-05-27 |
1124330386 | Favorable Network Solutions | Residential Treatment Facility, Emotionally Disturbed Children | 881 Memorial Dr Se, Suite 213, Atlanta, GA 30316-1270 | 2010-07-04 |
1467687665 | Positive Impact Hhs, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 934 Garden Walk Blvd. # 903, College Park, GA 30349-8508 | 2009-05-18 |
1932342235 | The Sanctuary House, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 500 John Deere Rd Nw, Monroe, GA 30656-4769 | 2009-04-16 |
1417198458 | Naciema Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 3200 Stone Rd Sw Apt W8, Atlanta, GA 30331-2920 | 2009-03-22 |
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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.