SECOND NATURE BLUE RIDGE


Address: 236 File Street, Clayton, GA 30525-3023
Phone: 7062122037

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 322D00000X Residential Treatment Facility, Emotionally Disturbed Children 50017 GA Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
GA STATE LICENSE NUMBER 50017 01

Office Location

Street Address 236 FILE STREET
City CLAYTON
State GA
Zip Code 30525-3023

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710218805 Anthony Issenmann Marriage & Family Therapist 236 File Street, Clayton, GA 30525 2010-01-29

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 322D00000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City CLAYTON
Zip Code 30525

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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.

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